Overt and Subclinical Hypothyroidism

@article{Khandelwal2012OvertAS,
  title={Overt and Subclinical Hypothyroidism},
  author={Deepak Khandelwal and Nikhil Tandon},
  journal={Drugs},
  year={2012},
  volume={72},
  pages={17-33}
}
Hypothyroidism denotes deficient production of thyroid hormone by the thyroid gland and can be primary (abnormality in thyroid gland itself) or secondary/central (as a result of hypothalamic or pituitary disease). The term ‘subclinical hypothyroidism’ is used to define that grade of primary hypothyroidism in which there is an elevated thyroid-stimulating hormone (TSH) concentration in the presence of normal serum free thyroxine (T4) and triiodothyronine (T3) concentrations. Subclinical… 

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Transient high thyroid stimulating hormone and hypothyroidism incidence during follow up of subclinical hypothyroidism

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Macro-TSH in patients with primary hypothyroidism due to autoimmune thyroiditis

Clinical cases of patients with a combination of the macro-TSH phenomenon and primary hypothyroidism due to AIT are presented.

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Thyroid symptomatology differs significantly across spectrum of hypothyroidism, being significantly worse in SPH and following euthyroidism restoration in subjects with SPH.

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The epidemiology, etiology, clinical sign and symptoms, diagnosis, complications, and management of hypothyroidism in modern medicine and a comparative treatment by the Unani system of medicine are discussed.

The Effects of Metformin on Thyroid Function among Patients with Subclinical Hypothyroidism and Coexisting Metabolic Syndrome

The data showed that rainfall metformin reduced the TSH level in subclinical hypothyroid patients, especially in patients with TSH baseline level higher than 5mIU/l and TPO-ab positive Patients, and a reduction in metabolic element was observed.
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References

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Subclinical hypothyroidism

The goal of the therapy for the pregnant women with subclinical hypothy-roidism is serum TSH less than 2.5 mIU/L and L-thyroxine substitutive therapy is recommended when TSH is above 10 m IU/L.

Subclinical Hypothyroidism

Therapy for milder forms of hypothyroidism is controversial and the controversy surrounding therapy will not be resolved until more randomized studies are available for the subgroup of patients with TSH <10 mIU/L, and until the question of cardiovascular risk factors is further clarified.

Subclinical Hypothyroidism in Children: Normal Variation or Sign of a Failing Thyroid Gland?

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  • Medicine, Biology
    International journal of pediatric endocrinology
  • 2010
Since few cases of pediatric SCH progress to OH, treatment can be deferred, and periodic follow-up testing may be the preferred strategy, with elevated thyroid antibodies or a goiter being considered risk factors for eventual OH.

Mechanisms related to the pathophysiology and management of central hypothyroidism

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High doses of levothyroxine for T4 replacement therapy have not been confirmed, but might need to be higher than presently used empirically in patients with CH and should be adjusted according to age and other hormone deficiencies, to achieve free T4 concentrations in the upper end of the normal range.

Hypothyroidism in the Elderly: Pathophysiology, Diagnosis and Treatment

In elderly patients on replacement therapy, care should include estimation of serum TSH level once or twice a year, with small dosage adjustments of levothyroxine sodium to keep serum T SH level within the normal range.

Epidemiology and prevention of clinical and subclinical hypothyroidism.

Controversy exists as to whether healthy adults would benefit from screening for autoimmune thyroid disease because a significant proportion of subjects tested will have evidence of mild thyroid failure.

Central hypothyroidism

The vast majority of patients with CH is treated with standard levo-thyroxine (L-T4) therapy which is tailored according to FT4 circulating levels that should be maintained in the normal range.

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  • W. Hueston
  • Medicine, Biology
    American family physician
  • 2001
The management of hypothyroidism focuses on ensuring that patients receive appropriate thyroid hormone replacement therapy and monitoring their response, and the addition of triiodothyronine in a low dosage may be beneficial in some patients who continue to have mood or memory problems.

The Colorado thyroid disease prevalence study.

The results confirm that thyroid dysfunction is common, may often go undetected, and may be associated with adverse health outcomes that can be avoided by serum TSH measurement.

Subclinical thyroid disease

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