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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83 Citations

Management of Subclinical Hypothyroidism: The Thyroidologists’ View

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.

Hypothyroidism: Investigation and management

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.

Overt Hypothyroidism in Hospitalized Patients: Clinical Characteristics

Clinical manifestations of in-patients with overt hypothyroidism include multiple non-specific symptoms, mainly weakness and constipation, while typical “hypothyroid” symptoms such as cold intolerance and weight gain are often overlooked.

Trends in thyroid hormone prescribing and consumption in the UK

Analysis of the full costs of 28-day dispensing balanced against the potential savings of reduced wastage of thyroid medications, suggests that this is unlikely to be an economically effective public health policy.

The Thyroid Registry: Clinical and Hormonal Characteristics of Adult Indian Patients with Hypothyroidism

Most of the patients as observed in this registry received treatment with levothyroxine based on TSH levels alone, thus highlighting the need for awareness and scientific education among clinicians in India.

TSH levels and risk of miscarriage in women on long-term levothyroxine: a community-based study.

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.

Drug Interactions with Levothyroxine Therapy in Patients with Hypothyroidism: Observational Study in General Practice

Clinicians should carefully consider adjusting levothyroxine therapy in presence of concomitant drugs, such as proton-pump inhibitors, which may reduce lev Timothyroxine bioavailability.

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.

Respiratory Manifestations of Hypothyroidism: A Systematic Review.

Mechanistic data linking hypothyroidism and respiratory function are at best limited and this area of research is open for retesting hypotheses, using appropriate study designs and methods.

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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