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
...eatment
...HYROXINE THERAPY
...vothyroxine is recommended as the p...
...evothyroxine placement therapy has three main...
...h it may be helpful to follow changes in clinical...
...biomarkers of thyroid hormone action are not recom...
...eral populations ( L , W )624...
...il patients, high-risk thyroid cancer patients, p...
...hildhood hypothyroidism ( M , S )Note: Switches...
...ecause use of different levothyroxine product...
...lthough there are preliminary small st...
...istration of food and levothyroxine is likely...
...nds that, where feasible, levothyroxine sh...
...ents in whom levothyroxine dose requirem...
...iation or discontinuation of estrogen and...
...ng on a starting dose of levothyroxine,...
...ne therapy should be initiated as an...
...deleterious health effects of iatrog...
...dverse effects of thyroid hormone deficiency...
...eived allergy or intolerance to levothryoxi...
...commends considering patients’ underl...
...oals of hypothyroidism are the same for patien...
...patients, levothyroxine should general...
...n of daily levothyroxine is not suc...
...re is insufficient evidence of benefit to re...
...e established instruments used to...
...inority of patients with hypothyroid...
...ypothyroidism in Pregnant Women, Infants, and...
...nt women with overt hypothyroidism sh...
...othyroxine replacement at a dose of 10-15 μg...
...with overt hypothyroidism should receive...
...the low risks of levothyroxine replacement thera...
...econdary Hypothyr...
...patients with secondary hypothyroidism, the primar...
...h it may be helpful to follow changes...
...ients with secondary hypothyroidism...
...vothyroxine in Euthyroid Indivi...
...recommends against the use of levothyr...
...nds against the routine use of levothyrox...
...ds against the treatment of obesity with levot...
...ATA recommends against the treatment of urtica...
...itious thyrotoxicosis should be tr...
...OTHER THAN LEVOTHYROXINE ALONE...
The ATA recommends that levothyroxine be consid...
...here is no consistently strong evi...
...or patients with primary hypothyroidism who fee...
...rently, genetic testing is not recommended a...
...erm outcome data in hypothyroid pa...
...ough some uncontrolled and nonrandomiz...
...ATA recommends against the use of synthetic li...
...mmends against the routine use of compounde...
...ds against the use of dietary supplem...
...son’s Syndrome
...e no credible scientific data to support the exist...
...SPITALIZED PATIEN...
...spitalized, non-critically ill patients w...
The therapeutic goal of levothyroxine...
...but not critically ill patients, oral lev...
...hospitalized but not critically ill patients...
...ecommends against the routine use of liothyro...
...edema Com...
...d hormone replacement for myxedema coma...
...ticoid coverage should be employed as par...
...sibility that thyroxine conversion to trii...
...s levothyroxine treatment in severely hypoth...
...ommends against the use of levothyroxine as...
...mends against the use of liothyroni...
...THYROID HORMONE ANALOG...
...ugh preclinical data suggest that the conc...
...peutic goals of the treatment of patients...
...gh preliminary data from small case series suggest...
...THICS FRAMEW...
...principles in levothyroxine treatment for hypot...
...ble 1. Thyroid Hormone Preparations...
...edications Potentially Affecting Levothyroxine Dos...
Table 3. Potential Concerns About Long-Term...
Unanswered Questions (Areas Needing Further Research)
...swered Questions (Areas Needing Fur...