Document Detail


Hypothyroidism: an update.
MedLine Citation:
PMID:  22962987     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Hypothyroidism is a clinical disorder commonly encountered by the primary care physician. Untreated hypothyroidism can contribute to hypertension, dyslipidemia, infertility, cognitive impairment, and neuromuscular dysfunction. Data derived from the National Health and Nutrition Examination Survey suggest that about one in 300 persons in the United States has hypothyroidism. The prevalence increases with age, and is higher in females than in males. Hypothyroidism may occur as a result of primary gland failure or insufficient thyroid gland stimulation by the hypothalamus or pituitary gland. Autoimmune thyroid disease is the most common etiology of hypothyroidism in the United States. Clinical symptoms of hypothyroidism are nonspecific and may be subtle, especially in older persons. The best laboratory assessment of thyroid function is a serum thyroid-stimulating hormone test. There is no evidence that screening asymptomatic adults improves outcomes. In the majority of patients, alleviation of symptoms can be accomplished through oral administration of synthetic levothyroxine, and most patients will require lifelong therapy. Combination triiodothyronine/thyroxine therapy has no advantages over thyroxine monotherapy and is not recommended. Among patients with subclinical hypothyroidism, those at greater risk of progressing to clinical disease, and who may be considered for therapy, include patients with thyroid-stimulating hormone levels greater than 10 mIU per L and those who have elevated thyroid peroxidase antibody titers.
Authors:
David Y Gaitonde; Kevin D Rowley; Lori B Sweeney
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American family physician     Volume:  86     ISSN:  1532-0650     ISO Abbreviation:  Am Fam Physician     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-09-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1272646     Medline TA:  Am Fam Physician     Country:  United States    
Other Details:
Languages:  eng     Pagination:  244-51     Citation Subset:  AIM; IM    
Affiliation:
Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA, USA.
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