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

...reatmen...

...VOTHYROXINE TH...

...othyroxine is recommended as the preparation o...

...vothyroxine placement therapy has t...

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

...iomarkers of thyroid hormone action are not...

...al populations ( L , W )624...

...ts, high-risk thyroid cancer patients,...

...ildhood hypothyroidism ( M , S )Note: Swi...

...ause use of different levothyroxine produ...

...ugh there are preliminary small studies...

Because co-administration of food and levothyr...

...recommends that, where feasible, le...

...in whom levothyroxine dose requirements are much...

...nitiation or discontinuation of estrogen and a...

...hen deciding on a starting dose of l...

...rmone therapy should be initiated as an...

...eterious health effects of iatrogenic thyro...

...effects of thyroid hormone deficienc...

...gy or intolerance to levothryoxine ca...

...e ATA recommends considering patients’ under...

...tment goals of hypothyroidism are the same for...

...tients, levothyroxine should gener...

...prescription of daily levothyroxine is not su...

...is insufficient evidence of benefit to...

...established instruments used to measure h...

...nority of patients with hypothyroidism, but...

...sm in Pregnant Women, Infants, and Children...

...with overt hypothyroidism should receive...

In infants, levothyroxine replacement at...

...ldren with overt hypothyroidism should re...

...low risks of levothyroxine replaceme...

...condary Hypothyroi...

...atients with secondary hypothyroidism,...

...hough it may be helpful to follow c...

...with secondary hypothyroidism in whom the only a...

...yroxine in Euthyroid Individua...

...ngly recommends against the use of levothyroxine...

...he ATA recommends against the routine u...

...ds against the treatment of obesity with levothy...

...ATA recommends against the treatment of ur...

...ctitious thyrotoxicosis should be t...


...APIES OTHER THAN LEVOTHYROXI...

...mmends that levothyroxine be considered...

...sistently strong evidence of superiority...

...tients with primary hypothyroidism who feel u...

...ic testing is not recommended as a guide...

...h short-term outcome data in hypothyroid pa...

...e uncontrolled and nonrandomized data exist...

...ommends against the use of synthetic lioth...

...recommends against the routine use of compound...

...TA recommends against the use of dietary supplem...

...son’s Syndro...

...dible scientific data to support the e...


...ALIZED PATIENTS...

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

...therapeutic goal of levothyroxine replacement i...

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

...but not critically ill patients who are abo...

...commends against the routine use of liothyronine...

...yxedema C...

...ial thyroid hormone replacement for myxedem...

...cocorticoid coverage should be employe...

Given the possibility that thyroxine conversion...

...vothyroxine treatment in severely hypothyr...

The ATA recommends against the use...

...ends against the use of liothyronine as a f...


...THYROID HORMONE ANALOGS

...linical data suggest that the concept of thyromi...

...goals of the treatment of patients with geneti...

...ugh preliminary data from small case series sugge...


ETHICS FRAME...

...thical principles in levothyroxine tr...


...yroid Hormone PreparationsHaving t...


...Medications Potentially Affecting Levo...


...tential Concerns About Long-Term Combina...


Unanswered Questions (Areas Needing Further Research)

...estions (Areas Needing Further Research)...