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1. Thyroid hormones treatment for subclinical hypothyroidism Full Text available with Trip Pro

Thyroid hormones treatment for subclinical hypothyroidism Thyroid hormones treatment for subclinical hypothyroidism: a clinical practice guideline | The BMJ Intended for healthcare professionals Username * Password * Edition: Search form Search Search Thyroid hormones... Thyroid hormones treatment for subclinical hypothyroidism: a clinical practice guideline (Published 14 May 2019) Cite this as: BMJ 2019;365:l2006 Visual summary of recommendation or No thyroid hormones Thyroid hormones (...) Levothyroxine Interventions compared Recommendation Population Adults with subclinical hypothyroidism Does not apply to: May not apply to: Including: Women who are or trying to become pregnant Patients with no symptoms (diagnosed after screening) Patients with non-specific symptoms Patients with severe symptoms Patients with TSH above 20 mIU/L Young adults (such as <30 years) Elevated levels of thyroid stimulating hormone (TSH) Normal free T4 (thyroxine) levels We recommend against thyroid hormone therapy

2019 BMJ Rapid Recommendations

2. Thyroxine replacement for subfertile women with euthyroid autoimmune thyroid disease or subclinical hypothyroidism. (Abstract)

Thyroxine replacement for subfertile women with euthyroid autoimmune thyroid disease or subclinical hypothyroidism. Thyroid disease is the second most common endocrine disorder affecting women of reproductive age. Subclinical hypothyroidism is diagnosed by an elevated thyroid-stimulating hormone concentration with a normal concentration of free thyroxine hormone. Autoimmune thyroid disease (ATD) is diagnosed by the presence of thyroid autoantibodies, regardless of thyroid hormone levels (...) . Thyroxine may be a useful treatment for subfertile women with these two specific types of thyroid disease for improving pregnancy outcomes during assisted reproduction.To evaluate the efficacy and harms of levothyroxine replacement in subfertile women with subclinical hypothyroidism or with normal thyroid function and thyroid autoimmunity (euthyroid autoimmune thyroid disease, or euthyroid ATD) undergoing assisted reproduction.We searched the Cochrane Gynaecology and Fertility (CGF) Group specialised

2019 Cochrane

3. 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

4. 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

5. Thyroid Testing for Hypothyroidism: Clinical Effectiveness and Guidelines

Thyroid Testing for Hypothyroidism: Clinical Effectiveness and Guidelines Thyroid Testing for Hypothyroidism: Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Thyroid Testing for Hypothyroidism: Clinical Effectiveness and Guidelines Thyroid Testing for Hypothyroidism: Clinical Effectiveness and Guidelines Last updated: November 15, 2018 Project Number: RB1281-000 Product Line: Research Type: Devices and Systems Report Type: Summary of Abstracts Result type: Report (...) Question What is the effectiveness of assessing free T3 or T4 to screen for hypothyroidism? What is the effectiveness of assessing free T3 or T4 levels to monitor or adjust levothyroxine dose? What are the evidence-based guidelines regarding thyroid testing for screening or monitoring patients with hypothyroidism? Key Message Two systematic reviews, one non-randomized study, four evidence-based guidelines, and one systematic review of guidelines were identified regarding the assessment of free T3 or T4

2018 Canadian Agency for Drugs and Technologies in Health - Rapid Review

9. Helping physicians fatigued by TSH Screening and Subclinical Hypothyroidism

Helping physicians fatigued by TSH Screening and Subclinical Hypothyroidism Tools for Practice is proudly sponsored by the Alberta College of Family Physicians (ACFP). ACFP is a provincial, professional voluntary organization, representing more than 4,800 family physicians, family medicine residents, and medical students in Alberta. Established over sixty years ago, the ACFP strives for excellence in family practice through advocacy, continuing medical education and primary care research (...) . www.acfp.ca December 9, 2019 (en français) Helping physicians fatigued by TSH Screening and Subclinical Hypothyroidism Clinical Question: Is there evidence for screening for thyroid function or treating subclinical hypothyroidism? Bottom Line: There is no randomized controlled trial (RCT) of screening for thyroid function [ordering thyroid stimulating hormone (TSH) in non-pregnant healthy people]. Despite approximately 20 RCTs, there are no patient-oriented benefits (like preventing cardiovascular disease

2019 Tools for Practice

10. 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

11. General medicine: Low-dose levothyroxine did not improve symptoms in asymptomatic older people with subclinical hypothyroidism Full Text available with Trip Pro

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

2018 Evidence-Based Medicine

12. 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

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

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

14. Prepregnancy Hypothyroidism versus Gestational Hypothyroidism: A Comparative Study. Full Text available with Trip Pro

Prepregnancy Hypothyroidism versus Gestational Hypothyroidism: A Comparative Study. Hypothyroidism managed inadequately in pregnancy may have grave outcomes for both mother and baby. Understanding pregnancy outcomes in our country with low awareness about thyroid diseases is important.The objectives of the study were to evaluate demographic features and biochemical parameters in patients with prepregnancy hypothyroidism versus patients diagnosed to have primary hypothyroidism during pregnancy (...) and to assess pregnancy outcomes.Prospective design.The study was conducted in a tertiary care center in Bengaluru for 2 years. The patients were divided into two groups - Group I: Prepregnancy hypothyroidism and Group II: Hypothyroid during pregnancy. They were further staged according to ESI guidelines as subclinical or overt hypothyroidism.Chi-square and Mann-Whitney test.A total of 452 pregnant women with hypothyroidism were analyzed. The data of 371 delivered pregnancies were available. Group I and II

2019 Indian journal of endocrinology and metabolism Controlled trial quality: uncertain

15. Subclinical Hypothyroidism: A Review. (Abstract)

Subclinical Hypothyroidism: A Review. Subclinical hypothyroidism, defined as an elevated serum thyrotropin (often referred to as thyroid-stimulating hormone, or TSH) level with normal levels of free thyroxine (FT4) affects up to 10% of the adult population.Subclinical hypothyroidism is most often caused by autoimmune (Hashimoto) thyroiditis. However, serum thyrotropin levels rise as people without thyroid disease age; serum thyrotropin concentrations may surpass the upper limit (...) of the traditional reference range of 4 to 5 mU/L among elderly patients. This phenomenon has likely led to an overestimation of the true prevalence of subclinical hypothyroidism in persons older than 70 years. In patients who have circulating thyroid peroxidase antibodies, there is a greater risk of progression from subclinical to overt hypothyroidism. Subclinical hypothyroidism may be associated with an increased risk of heart failure, coronary artery disease events, and mortality from coronary heart disease

2019 JAMA

16. Thyroid replacement therapy, thyroid stimulating hormone concentrations, and long term health outcomes in patients with hypothyroidism: longitudinal study. Full Text available with Trip Pro

Thyroid replacement therapy, thyroid stimulating hormone concentrations, and long term health outcomes in patients with hypothyroidism: longitudinal study. To explore whether thyroid stimulating hormone (TSH) concentration in patients with a diagnosis of hypothyroidism is associated with increased all cause mortality and a higher risk of cardiovascular disease and fractures.Retrospective cohort study.The Health Improvement Network (THIN), a database of electronic patient records from UK primary (...) care.Adult patients with incident hypothyroidism from 1 January 1995 to 31 December 2017.TSH concentration in patients with hypothyroidism.Ischaemic heart disease, heart failure, stroke/transient ischaemic attack, atrial fibrillation, any fractures, fragility fractures, and mortality. Longitudinal TSH measurements from diagnosis to outcomes, study end, or loss to follow-up were collected. An extended Cox proportional hazards model with TSH considered as a time varying covariate was fitted for each

2019 BMJ

17. Chinese herbal medicines for hypothyroidism. (Abstract)

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

18. Exercise training improves quality of life in women with subclinical hypothyroidism: a randomized clinical trial. Full Text available with Trip Pro

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

2018 Archives of endocrinology and metabolism Controlled trial quality: uncertain

19. Does Sex Bias Play a Role for Dissatisfied Patients With Hypothyroidism? Full Text available with Trip Pro

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

2018 Journal of the Endocrine Society

20. Mild Hypothyroidism in Childhood: Who, When, and How Should Be Treated? Full Text available with Trip Pro

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

2018 Journal of the Endocrine Society

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