Management of DR-TB ADR: Hypothyroidism

Figure: Symptoms of Hypothyroidism

Suspected agent(s): Ethionamide (Eto), Para Aminosalicylic Acid (PAS)

Suggested Management Strategies:

• In cases of hypothyroidism, the opinion of a general physician/ endocrinologist may be taken.
• Eto /PAS can be continued with the introduction of thyroxine.

Points to Note

• Symptoms of hypothyroidism include fatigue, somnolence, cold intolerance, dry skin, coarse hair and constipation, as well as occasional depression and inability to concentrate (Figure above).
• In cases with abnormal weight gain, hypothyroidism may be ruled out.
• It is completely reversible upon discontinuation of PAS and/or Eto.
• Combination of Eto with PAS is more frequently associated with hypothyroidism than when each individual drug is used.