Hypothyroidism

Publication Date: December 12, 2014

Key Points

Key Points

Levothyroxine should remain the standard of care for treating hypothyroidism.

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

...eatment

...OTHYROXINE THERAPY

...e is recommended as the preparation of choic...

...thyroxine placement therapy has three...

...ough it may be helpful to follow changes...

...e biomarkers of thyroid hormone action are not...

...pulations ( L , W )624...

...ents, high-risk thyroid cancer patients, p...

Early childhood hypothyroidism ( M , S )Note...

...use of different levothyroxine products may...

...hough there are preliminary small stu...

...ecause co-administration of food and lev...

...ommends that, where feasible, levothy...

...n patients in whom levothyroxine do...

...itiation or discontinuation of estrogen and...

...deciding on a starting dose of levothyrox...

...d hormone therapy should be initiated as an...

...eleterious health effects of iatrogenic...

...se effects of thyroid hormone deficiency inclu...

...allergy or intolerance to levothryo...

...ecommends considering patients’...

...oals of hypothyroidism are the same for patients...

...s, levothyroxine should generally be initi...

If prescription of daily levothyroxine is n...

...ere is insufficient evidence of be...

...hed instruments used to measure hyp...

...f patients with hypothyroidism, but normal s...

...ypothyroidism in Pregnant Women, Infants,...

...regnant women with overt hypothyroidism sho...

...evothyroxine replacement at a dose...

All children with overt hypothyroidism should...

...e to the low risks of levothyroxine replaceme...

...ry Hypothyroidis...

...patients with secondary hypothyroidi...

...gh it may be helpful to follow changes...

...patients with secondary hypothyroidism in wh...

...oxine in Euthyroid Individ...

The ATA strongly recommends against the use o...

...nds against the routine use of levothyroxine for t...

...ATA recommends against the treatment of o...

The ATA recommends against the trea...

...ctitious thyrotoxicosis should be treated...


...HER THAN LEVOTHYROXINE ALONE...

...ds that levothyroxine be considered as rou...

...o consistently strong evidence of sup...

...th primary hypothyroidism who feel unwell on l...

...enetic testing is not recommended as a guide to se...

...ough short-term outcome data in hypothy...

...uncontrolled and nonrandomized data exist concer...

...ommends against the use of synthetic liothyronin...

...recommends against the routine use of compoun...

...nds against the use of dietary supplements, nutr...

Wilson’s Sy...

...credible scientific data to support the ex...


...TALIZED PATIENTS...

...hospitalized, non-critically ill patients with...

...goal of levothyroxine replacement in no...

...but not critically ill patients,...

...spitalized but not critically ill pa...

...TA recommends against the routine use...

...dema Coma

...l thyroid hormone replacement for myxedema com...

...glucocorticoid coverage should be employed...

...possibility that thyroxine conversion to triiod...

...evothyroxine treatment in severely...

...mends against the use of levothyroxine as a f...

...commends against the use of liothyro...


USE OF THYROID HORMONE ANAL...

...preclinical data suggest that the...

...e therapeutic goals of the treatment of patients...

...preliminary data from small case ser...


...S FRAMEWORK...

...inical ethical principles in levothyroxine t...


.... Thyroid Hormone PreparationsHaving troub...


...cations Potentially Affecting Levothyrox...


...otential Concerns About Long-Term Combinat...


Unanswered Questions (Areas Needing Further Research)

...d Questions (Areas Needing Further Research)...