When should I consider referring a patient with myxoedema coma to secondary care?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Consider referring a patient with myxoedema coma to secondary care immediately. Myxoedema coma is a life-threatening emergency caused by severe hypothyroidism requiring urgent specialist management, including intensive monitoring and treatment that cannot be provided in primary care.

Referral should be made as soon as myxoedema coma is suspected or diagnosed to ensure prompt initiation of intravenous thyroid hormone replacement, supportive care, and management of precipitating factors in a hospital setting.

Educational content only. Always verify information and use clinical judgement.