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
...Treatment...
...LEVOTHYROXINE...
...ine is recommended as the preparation of choi...
...e placement therapy has three main go...
...be helpful to follow changes in clinical...
...rs of thyroid hormone action are not...
...opulations ( L , W )6...
...nts, high-risk thyroid cancer patients...
...ly childhood hypothyroidism ( M , S )Note: Swi...
...se use of different levothyroxine products may so...
...here are preliminary small studies suggesting t...
...co-administration of food and levothyroxine...
...ends that, where feasible, levothyroxine s...
...s in whom levothyroxine dose requirements are much...
...n or discontinuation of estrogen and androgens sh...
When deciding on a starting dose of...
...oid hormone therapy should be initiated as an...
...erious health effects of iatrogeni...
...fects of thyroid hormone deficienc...
...ved allergy or intolerance to levothryoxine c...
...ATA recommends considering patients’ u...
...ment goals of hypothyroidism are the same for...
...ents, levothyroxine should generally be initi...
...ion of daily levothyroxine is not succe...
...s insufficient evidence of benefit to recomm...
Of the established instruments used to measure...
...patients with hypothyroidism, but normal serum TS...
...Hypot...
...men with overt hypothyroidism should receive...
...infants, levothyroxine replacement...
...ldren with overt hypothyroidism shou...
...to the low risks of levothyroxine replacemen...
...Secondary Hypothyroid...
...h secondary hypothyroidism, the primary biochemic...
...ay be helpful to follow changes in clin...
...atients with secondary hypothyroidism in w...
...Levothyr...
...ATA strongly recommends against the use o...
...ATA recommends against the routine use of levo...
...mmends against the treatment of obesi...
...e ATA recommends against the treatment of urticar...
...ctitious thyrotoxicosis should be...
...THERAPIES OTHER THAN LE...
...nds that levothyroxine be considered as ro...
...ere is no consistently strong evidence of supe...
...with primary hypothyroidism who feel unwell o...
...urrently, genetic testing is not r...
...-term outcome data in hypothyroid pat...
...uncontrolled and nonrandomized data exist...
...commends against the use of synthetic lioth...
...ends against the routine use of compound...
...mmends against the use of dietary supplements, nut...
...Wilson’s...
...e are no credible scientific data to suppor...
...HOSPITALIZED PAT...
...lized, non-critically ill patients with a pre...
...goal of levothyroxine replacement in noncriti...
...alized but not critically ill patients, o...
...hospitalized but not critically ill pati...
...ends against the routine use of liothyronine as...
...Myxedema...
...tial thyroid hormone replacement for myxedema...
...corticoid coverage should be employed as part of t...
...the possibility that thyroxine conversion to...
...ntravenous levothyroxine treatment in seve...
...nds against the use of levothyroxine as a form...
...commends against the use of liothyronin...
...US...
...nical data suggest that the concept o...
...utic goals of the treatment of patients with ge...
Although preliminary data from small c...
...ETHICS FRAMEWOR...
...ical principles in levothyroxine treatment fo...
...id Hormone Preparations Thyroid Hormo...
.... Medications Potentially Affecting Levothyr...
...Table 3. Potential...
Unanswered Questions (Areas Needing Further Research)
...Unanswered Questi...