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

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.