Hypothyroidism
Key Points
Key Points
There is no consistently strong evidence for the superiority of alternative preparations (e.g., levothyroxine–liothyronine combination therapy or thyroid extract therapy) over monotherapy with levothyroxine in improving health outcomes.
For patients who feel unwell while taking levothyroxine therapy there is currently insufficient evidence to support the routine use of combination therapy due to uncertainty about the long-term risk-benefit ratio.
Future research needs include the development of superior biomarkers of euthyroidism to supplement the use of serum TSH measurements and long term trials testing the health outcomes of combination therapy or thyroid extract therapy.
Treatment
...atment
...THYROXINE THERAP...
...ne is recommended as the preparation of choice fo...
...ine placement therapy has three main goals. Th...
...be helpful to follow changes in clini...
...s of thyroid hormone action are not recommended...
...populations ( L , W )624...
...rail patients, high-risk thyroid cancer patients...
Early childhood hypothyroidism ( M , S )No...
...ecause use of different levothyroxine pro...
...there are preliminary small studies suggestin...
...ause co-administration of food and levothyroxi...
...TA recommends that, where feasible, levothyroxin...
...ients in whom levothyroxine dose r...
...nitiation or discontinuation of es...
...eciding on a starting dose of levothyroxin...
...rmone therapy should be initiated as an...
...us health effects of iatrogenic th...
...verse effects of thyroid hormone deficien...
...gy or intolerance to levothryoxine can be manage...
...e ATA recommends considering patients’ underlyi...
...eatment goals of hypothyroidism are the same for p...
...ients, levothyroxine should generally be initia...
If prescription of daily levothyroxine...
...is insufficient evidence of benefit to r...
...established instruments used to measure...
...minority of patients with hypothyr...
...ism in Pregnant Women, Infants, an...
...nant women with overt hypothyroidism s...
...infants, levothyroxine replacement at a...
...en with overt hypothyroidism shoul...
...o the low risks of levothyroxine r...
...ary Hypothyroidis...
...n patients with secondary hypothyroidism, the...
...it may be helpful to follow changes in...
...ients with secondary hypothyroidism in whom the o...
...oxine in Euthyroid Individ...
...strongly recommends against the use...
...mmends against the routine use of le...
...ATA recommends against the treatment of obesity wi...
...ends against the treatment of urticar...
...toxicosis should be treated with dis...
...PIES OTHER THAN LEVOTHYROXINE ALONE...
...ecommends that levothyroxine be con...
...re is no consistently strong evidence of super...
...with primary hypothyroidism who feel u...
...ic testing is not recommended as a guide to sele...
...gh short-term outcome data in hypothyroid p...
...ough some uncontrolled and nonrandomiz...
...recommends against the use of synthe...
...ds against the routine use of compounded th...
...ATA recommends against the use of di...
...on’s Syndrome...
...o credible scientific data to support th...
...OSPITALIZED PATIENTS...
...spitalized, non-critically ill patients...
...utic goal of levothyroxine replacement in nonc...
...r hospitalized but not critically ill patien...
...hospitalized but not critically il...
...ommends against the routine use of liothyron...
...xedema Co...
...al thyroid hormone replacement for myxed...
...mpiric glucocorticoid coverage should be em...
...e possibility that thyroxine conversion to tri...
...ntravenous levothyroxine treatment in seve...
...commends against the use of levothyroxine as a for...
...recommends against the use of liothyronine as a fo...
...OF THYROID HORMONE ANALOG...
...eclinical data suggest that the conce...
...e therapeutic goals of the treatment of patients...
...ugh preliminary data from small ca...
...S FRAMEWORK
...l principles in levothyroxine treatmen...
...1. Thyroid Hormone PreparationsHav...
...2. Medications Potentially Affecting Levothyroxin...
...3. Potential Concerns About Long-Term Combi...
Unanswered Questions (Areas Needing Further Research)
...tions (Areas Needing Further Research)...