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
Treatmen...
...VOTHYROXINE THER...
...ine is recommended as the preparation o...
...ne placement therapy has three main goals. Thes...
...though it may be helpful to follow chang...
...ers of thyroid hormone action are...
...opulations ( L , W )624...
...nts, high-risk thyroid cancer patients, pregnant...
...childhood hypothyroidism ( M , S )...
Because use of different levothyroxine...
...here are preliminary small studies suggesting that...
...e co-administration of food and levothyroxine...
...ommends that, where feasible, levothyroxine...
...ts in whom levothyroxine dose requ...
...scontinuation of estrogen and androgens s...
...eciding on a starting dose of levothyroxin...
...e therapy should be initiated as an in...
...ious health effects of iatrogenic thyrotox...
...he adverse effects of thyroid horm...
...eived allergy or intolerance to levothryox...
...he ATA recommends considering patients’ un...
...als of hypothyroidism are the same for pat...
...tients, levothyroxine should generally b...
...tion of daily levothyroxine is not successful in m...
...ufficient evidence of benefit to r...
...stablished instruments used to measure hypoth...
...of patients with hypothyroidism, but normal seru...
...ism in Pregnant Women, Infants, and Chi...
...nant women with overt hypothyroidis...
...fants, levothyroxine replacement at a dose...
...ll children with overt hypothyroidism...
...to the low risks of levothyroxine replacement ther...
Secondary Hypothy...
...ts with secondary hypothyroidism,...
...gh it may be helpful to follow changes...
...nts with secondary hypothyroidism in whom...
...xine in Euthyroid Individuals...
...trongly recommends against the use of le...
The ATA recommends against the routine use of...
...e ATA recommends against the treatment...
...ds against the treatment of urticaria with le...
...thyrotoxicosis should be treated wit...
...ES OTHER THAN LEVOTHYROXINE AL...
...ATA recommends that levothyroxine be considered a...
...re is no consistently strong evidence of superio...
...patients with primary hypothyroidism who feel...
...genetic testing is not recommended a...
...-term outcome data in hypothyroid patients su...
...hough some uncontrolled and nonrandom...
...e ATA recommends against the use of synthet...
...recommends against the routine use...
...ds against the use of dietary supplem...
...n’s Syndrome...
...credible scientific data to support the...
HOSPITALIZED PATIEN...
...zed, non-critically ill patients wi...
...c goal of levothyroxine replacement in...
...talized but not critically ill pati...
...ized but not critically ill patients who...
...recommends against the routine use of lio...
Myxedema Co...
...tial thyroid hormone replacement for myxedema...
...cocorticoid coverage should be employed...
...possibility that thyroxine conversion to tri...
...ntravenous levothyroxine treatment in severely...
...recommends against the use of levothyr...
...A recommends against the use of liothyr...
...THYROID HORMONE ANALOGS...
...lthough preclinical data suggest tha...
...ic goals of the treatment of patient...
...ugh preliminary data from small case series su...
...THICS FRAMEWOR...
...ical ethical principles in levothyroxine t...
...ble 1. Thyroid Hormone PreparationsHaving tro...
Table 2. Medications Potentially A...
...able 3. Potential Concerns About Long-Term...
Unanswered Questions (Areas Needing Further Research)
...swered Questions (Areas Needing Further Res...