Management of hypothyroidism in adults

@article{Vaidya2008ManagementOH,
  title={Management of hypothyroidism in adults},
  author={Bijay Vaidya and Simon H S Pearce},
  journal={BMJ : British Medical Journal},
  year={2008},
  volume={337}
}
Hypothyroidism is one of the commonest chronic disorders in Western populations. In the United Kingdom, the annual incidence of primary hypothyroidism in women is 3.5 per 1000 and in men 0.6 per 1000.1 During 2006 12 million prescriptions for levothyroxine (50 μg or 100 μg tablets) were dispensed in England, equivalent to about 1.6 million people taking long term thyroid replacement therapy, about 3% of the population.2 The management of hypothyroidism is generally considered straightforward… 

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A snapshot of the range of accepted clinical practice in this common condition is formed, for a 53-year-old woman with fatigue and difficulty losing weight, who has a serum TSH of 6.8 mU/l and strongly positive thyroid peroxidase antibodies, 95% of respondents would treat with levothyroxine.

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The aetiology, clinical features, investigation and management of hypothyroidism is outlined, with the significance of elevated TSH associated with thyroid hormones within normal range is controversial; thyroxine replacement may be beneficial in some cases.

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The majority of levothyroxine-treated women have early gestational TSH levels above the recommended targets with a strong risk of miscarriage at levels exceeding 4.5 mU/L, and there is an urgent need to improve the adequacy of thyroid hormone replacement in early pregnancy.

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Hypothyroidism after a cancer diagnosis: etiology, diagnosis, complications, and management.

Thyroid dysfunction can be easily overlooked in cancer patients because of the complexity of cancer's clinical picture, particularly in the pediatric population and the management of both hypothyroidism and the malignancy.

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Correlation between TSH levels and quality of life among subjects with well-controlled primary hypothyroidism

In patients with primary hypothyroidism, higher TSH values, even within the normal reference range, are associated with greater deterioration of HRQoL, indicating greater impairment in health-related quality of life with increasing TSHvalues.
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