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Hypothyroidism

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1. Treatment for hypothyroidism

Treatment for hypothyroidism Treatment for hypothyroidism We use cookies on this website. By using this site, you agree that we may store and access cookies on your device. Swedish Agency for Health Technology Assessment and Assessment of Social Services Treatment for hypothyroidism Share: Reading time approx. 5 minutes Hypothyroidism is due to an underactive thyroid gland. This means that the thyroid gland can’t make enough thyroid hormone to keep the body running normally. The major form (...) of thyroid hormone in the blood is Levothyroxine (T4), and Triiodothyronine (T3). The goal of therapy is to reverse all the clinical manifestations of hypothyroidism. This can be accomplished by oral administration of synthetic thyroxine (T4, levothyroxine). It has been suggested that the addition of T3 may be of benefit for some patients. Desiccated thyroid or thyroid extract refers to dried porcine thyroid glands in therapeutic use. The earliest oral treatment for hypothyroidism consisted of thyroid

2018 Swedish Council on Technology Assessement

5. Primary hypothyroidism

Primary hypothyroidism Primary hypothyroidism - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Primary hypothyroidism Last reviewed: February 2019 Last updated: June 2018 Summary Patients usually present with non-specific symptoms of weakness, lethargy, depression, and mild weight gain. Commonly, disease is sub-clinical. Physical examination may show dry skin, thick tongue, eyelid oedema, and bradycardia. Elevated TSH (...) and low free T4. Treatment is levothyroxine at a starting dose of 1.6 micrograms/kg daily or 25 micrograms daily in older patients or those with CAD. Over-treatment is uncommon but can lead to iatrogenic hyperthyroidism. Definition Hypothyroidism is a clinical state resulting from underproduction of the thyroid hormones T4 and T3. Franklyn JA. Hypothyroidism. Medicine. 2005;33:27-29. Most cases (95%) are due to primary hypothyroidism, a failure of the thyroid gland to produce thyroid hormones

2018 BMJ Best Practice

6. Central hypothyroidism

Central hypothyroidism Central hypothyroidism - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Central hypothyroidism Last reviewed: February 2019 Last updated: November 2017 Summary Symptoms of central hypothyroidism include those of primary hypothyroidism (fatigability, cold intolerance, weight gain), with or without other symptoms of hypopituitarism, including hypogonadism and secondary adrenal insufficiency. Signs (...) on physical examination may indicate hypothyroidism, including skin changes, hair loss, and bradycardia. Signs indicating a sellar or parasellar mass include papilloedema and visual field deficits (a bitemporal hemianopia). Diagnostic evaluation of central hypothyroidism includes serum TSH and free T4. In central hypothyroidism, free T4 is low and TSH may be low, normal, or minimally elevated. MRI may reveal sellar or parasellar pathology. Treatment of central hypothyroidism is by thyroid hormone

2017 BMJ Best Practice

7. Central Hypothyroidism related to Pituitary Adenomas: Low incidence of Central Hypothyroidism in patients with Acromegaly. (PubMed)

Central Hypothyroidism related to Pituitary Adenomas: Low incidence of Central Hypothyroidism in patients with Acromegaly. The most frequent cause of central hypothyroidism (CeH) is pituitary adenomas, but the mechanisms remain unclear.We investigated serum thyroid levels and GH/IGF-1 in CH in untreated patients with pituitary non-functioning and GH-secreting adenomas.This was a retrospective cross-sectional study of cases collected from Gunma University and Toranomon Hospitals between 2007

2019 Journal of Clinical Endocrinology and Metabolism

8. General medicine: Low-dose levothyroxine did not improve symptoms in asymptomatic older people with subclinical hypothyroidism

General medicine: Low-dose levothyroxine did not improve symptoms in asymptomatic older people with subclinical hypothyroidism Low-dose levothyroxine did not improve symptoms in asymptomatic older people with subclinical hypothyroidism | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using your (...) username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Low-dose levothyroxine did not improve symptoms in asymptomatic older people with subclinical hypothyroidism Article Text Commentary General medicine Low

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2018 Evidence-Based Medicine (Requires free registration)

9. Newborn Screening ACT Sheet [Low T4 and/or elevated TSH (Primary T4 followup TSH test)] Congenital Hypothyroidism

Newborn Screening ACT Sheet [Low T4 and/or elevated TSH (Primary T4 followup TSH test)] Congenital Hypothyroidism Aimer: This guideline is designed primarily as an educational resource for clinicians to help them provide quality medical care It should not be considered inclusive of all proper procedures and tests or exclusive of other procedures and tests that are reasonably directed to obtaining the same results. Adherence to this guideline does not necessarily ensure a successful medical (...) of the date this guideline was adopted, and to consider other medical and scientific information that become available after that date. © American College of Medical Genetics and Genomics, 2012 (Funded in part through MCHB/HRSA/HHS grant #U22MC03957) Newborn Screening ACT Sheet [Low T4 and/or elevated TSH (Primary T4 follow- up TSH test)] Congenital Hypothyroidism Differential Diagnosis: Primary and secondary congenital hypothyroidism (CH), transient CH, thyroxine binding globulin (TBG) deficiency

2018 American College of Medical Genetics and Genomics

10. TSH and FT4 concentrations in congenital central hypothyroidism and mild congenital thyroidal hypothyroidism. (PubMed)

TSH and FT4 concentrations in congenital central hypothyroidism and mild congenital thyroidal hypothyroidism. In central hypothyroidism (CeH), free thyroxine (FT4) concentrations are low, whereas thyrotropin (TSH) concentrations may be low, normal, or even slightly elevated due to reduced bioactivity. Congenital CeH (CCeH) may be isolated or part of multiple pituitary hormone deficiencies (MPHD).We tested our hypotheses that (1) TSH concentrations have a more U-shaped distribution in children (...) with CCeH compared with children with a normally functioning hypothalamic-pituitary-thyroid axis and (2) TSH concentrations in children with CCeH with MPHD are higher compared with children with isolated CCeH. We also studied whether FT4 levels are helpful in distinguishing CCeH from mild congenital hypothyroidism of thyroidal origin (CH-T).Dutch neonatal screening TSH and first diagnostic TSH and FT4 were analyzed in all children diagnosed with permanent CCeH between 1995 and 2012. Controls were

2018 Journal of Clinical Endocrinology and Metabolism

11. Diagnostic re-evaluation of congenital hypothyroidism in Macedonia: predictors for transient or permanent hypothyroidism (PubMed)

Diagnostic re-evaluation of congenital hypothyroidism in Macedonia: predictors for transient or permanent hypothyroidism Diagnostic re-evaluation is important for all patients with congenital hypothyroidism (CH) for determining the etiology and identifying transient CH cases. Our study is a first thyroxine therapy withdrawal study conducted in Macedonian CH patients for a diagnostic re-evaluation. We aimed to evaluate the etiology of CH, the prevalence of transient CH and identify predictive

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2018 Endocrine connections

12. Exercise training improves quality of life in women with subclinical hypothyroidism: a randomized clinical trial. (PubMed)

Exercise training improves quality of life in women with subclinical hypothyroidism: a randomized clinical trial. The aim was to evaluate the quality of life (HRQoL) in women with subclinical hypothyroidism (sHT) after 16 weeks of endurance training.In the first phase, a cross-sectional study was conducted in which 22 women with sHT (median age: 41.5 (interquartile range: 175) years, body mass index: 26.2 (8.7) kg/m2, thyroid stimulating hormone > 4.94 mIU/L and free thyroxine between 0.8

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2018 Archives of endocrinology and metabolism

13. Mild Hypothyroidism in Childhood: Who, When, and How Should Be Treated? (PubMed)

Mild Hypothyroidism in Childhood: Who, When, and How Should Be Treated? Mild hypothyroidism, also known as subclinical hypothyroidism (SH), is biochemically defined as serum TSH levels above the upper limit of the reference range, in the presence of normal serum concentrations of total T4 and free T4 (FT4). In the neonatal period, mild hypothyroidism can be defined by the presence of a TSH value between 6 and 20 mIU/L and normal FT4 levels. After the neonatal period, SH can be defined mild (...) if TSH ranges between 4.5 and 10 mIU/L. The management of mild hypothyroidism in childhood is challenging. The major concern is to establish whether this condition should always be considered an expression of mild thyroid dysfunction. Indeed, the effects of untreated mild hypothyroidism are still not completely defined. In the neonatal period, concern exists about neurocognitive outcome; in children, although there is no clear evidence of alterations in growth or neurocognitive development, subtle

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2018 Journal of the Endocrine Society

14. A 7-year study on the prevalence of congenital hypothyroidism in northern Iran (PubMed)

A 7-year study on the prevalence of congenital hypothyroidism in northern Iran Congenital hypothyroidism (CH) is one of the most common congenital endocrine disorders.The present study determined the prevalence and demographic characteristics of congenital hypothyroidism in the north of Iran.To determine the prevalence of congenital hypothyroidism based on transient and permanent types with demographic characteristics in Mazandaran province in northern Iran.This retrospective descriptive survey (...) analyzed the medical records of children with primary diagnosis of CH in health centers in all cities of Mazandaran Province between June 2009 and March 2016. To compare the study groups (CH type) in terms of quantitative and qualitative variables, the t-test and Chi-square test were used, respectively using the SPSS22. P-value <0.05 was considered as significant.Of 269,088 infants screened during the study period, 548 infants with primary congenital hypothyroidism were identified (a prevalence of 1

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2018 Electronic physician

15. Subclinical Hypothyroidism in Women Planning Conception and During Pregnancy: Who Should Be Treated and How? (PubMed)

Subclinical Hypothyroidism in Women Planning Conception and During Pregnancy: Who Should Be Treated and How? Subclinical hypothyroidism (SCH), a mild form of hypothyroidism defined as elevated TSH with normal free thyroxine levels, is a common diagnosis among women of reproductive age. In some, but not all, studies, it has been associated with infertility, an increased risk of adverse pregnancy and neonatal outcomes, and possibly with an increased risk of neurocognitive deficits in offspring (...) . Despite well-established recommendations on treatment of overt hypothyroid pregnant women, a consensus has not yet been reached on whether to treat women with SCH. This review focuses on examining the evidence informing the clinical strategy for using levothyroxine (LT4) in women with SCH during pregnancy and those who are planning conception. A crucial first step is to accurately diagnose SCH using the appropriate population-based reference range. For pregnant women, if this is unavailable

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2018 Journal of the Endocrine Society

16. Avelumab inducing hypothyroidism and hypoadrenalism: A case report and review of literature (PubMed)

Avelumab inducing hypothyroidism and hypoadrenalism: A case report and review of literature Avelumab is an anti-PD-L1 (programmed death-ligand 1) immune checkpoint inhibitor (ICIs) and the monoclonal antibody that constitutes a major development in the immunotherapy of cancer. In 2017, The European Medicine Agency (EMA) approved it as an orphan drug for treatment of gastric cancer. Avelumab has recently been approved in the United States, Europe and Japan for treatment of metastatic Merkel cell (...) of thyroiditis, hypothyroidism and adrenal insufficiency, which may require immediate attention and supportive treatment by immunosuppression and respective hormone replacement.

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2018 EXCLI journal

17. Does Sex Bias Play a Role for Dissatisfied Patients With Hypothyroidism? (PubMed)

Does Sex Bias Play a Role for Dissatisfied Patients With Hypothyroidism? The current state of the diagnosis and management of thyroid disease cannot be separated from the larger context of women's health for the following reasons: (1) the disproportionate incidence and prevalence of functional and structural thyroid diseases among women vs men; (2) the role of thyroid health on fertility, pregnancy, and postpartum; and (3) the challenge posed in managing the nonspecific symptoms of functional

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2018 Journal of the Endocrine Society

18. Risk factors associated with congenital hypothyroidism: a case-control study in southeast Iran (PubMed)

Risk factors associated with congenital hypothyroidism: a case-control study in southeast Iran Congenital hypothyroidism (CH) is known as one of the most common preventable cause of mental retardation. This study aimed to determine factors associated with CH in Iran.This case-control study was conducted on 160 children under one year old in Zahedan in southeast Iran in 2016. The neonates who were born from March 1, 2015 to March 19, 2016 and had undergone a screening program for CH were

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2018 Electronic physician

19. Chinese herbal medicines for hypothyroidism. (PubMed)

Chinese herbal medicines for hypothyroidism. The reduced production of thyroid hormones is the main feature of the clinical state termed hypothyroidism. In Chinese philosophical and medical theory, it results from Yang deficiency. Chinese herbal medicines (CHM) are thought to restore Yang and have been used in China to treat hypothyroidism for many years.To assess the effects of CHM for hypothyroidism.We searched The Cochrane Library, MEDLINE, EMBASE, the Chinese Biomedical Literature Database (...) on Disc, and the China National Knowledge Infrastructure for randomised clinical trials (RCTs). The date of the last search was September 2014 for all databases. We also searched for ongoing trials in trial registers.We considered RCTs of CHM alone or combined with thyroid hormone therapy compared with no treatment, placebo or thyroid hormone therapy. We also planned to compare different formulae of CHM with each other, alone or combined with thyroid hormone therapy. Hypothyroid individuals had

2015 Cochrane

20. Relation of Subclinical Hypothyroidism is Associated With Cardiovascular Events and All-Cause Mortality in Adults With High Cardiovascular Risk

Relation of Subclinical Hypothyroidism is Associated With Cardiovascular Events and All-Cause Mortality in Adults With High Cardiovascular Risk The aim of this study was to determine the association between subclinical hypothyroidism and cardiovascular (CVD) events, and mortality using the atherosclerotic CVD risk score. We carried out an observational study in a prospective cohort that was followed up for 12 years. The study included 3,021 participants aged ≥ 40 years at baseline from (...) the Ansung cohort, part of the Korean Genome and Epidemiology Study. Cox regression models were constructed to evaluate the hazards ratio (HR) and 95% confidence interval (CI) for all-cause mortality and CVD events in groups classified according to thyroid status. Subgroup analysis was performed with a cut-off age of 65 years or 7.5% of the 10-year atherosclerotic CVD risk score. The subclinical hypothyroidism group in the highest quartile of thyroid-stimulating hormone (>6.57 mIU/L) had a significantly

2018 EvidenceUpdates

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