Hashimoto Thyroiditis (Hypothyroidism)

Hashimoto thyroiditis gradually reduces the thyroid's ability to produce hormone. The usual laboratory pattern is a raised TSH with a low free T4 once overt hypothyroidism develops; a raised TSH with a normal free T4 indicates subclinical disease. For nursing care, the practical priorities are to recognize the hypometabolic pattern, give levothyroxine in a way that preserves absorption, use a cautious starting dose when cardiac reserve is limited, and identify myxedema coma before the word coma distracts from the immediate airway, breathing, and circulation threat.