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Guidelines for the Treatment of Hypothyroidism

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https://www.readbyqxmd.com/read/28931318/thyroid-function-testing-in-neonates-with-maternal-history-of-disease
#1
Lisa Underland, Lisa Kenigsberg, Kristina Derrick, Rebecca Crespi, Tara Kaushal, Leslie Lam
Maternal history of thyroid disease can cause congenital hypothyroidism due to thyroid-stimulatng hormone (TSH) blocking antibodies. No guidelines exist regarding testing beyond the newborn screen. TSH and T4 levels exhibit significant fluctuations after birth which complicates testing. A total of 561 newborns with thyroid function testing done for maternal history of thyroid disease in the newborn nursery were identified retrospectively via chart review, and thyroid disease status was assessed in 352. Newborn screening data were also obtained...
September 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28923288/delaying-thyroxine-until-positive-beta-human-chorionic-gonadotropin-is-safe-for-patients-receiving-fertility-therapy-applying-new-ata-guidelines-to-subclinical-hypothyroidism
#2
Alyse S Goldberg, Shoba Sujana Kumar, Ellen Greenblatt, Iliana C Lega, Heather Shapiro
OBJECTIVE: This study sought to examine the effect of changing TSH threshold recommendations from 2.5 to 4 mIU/L before fertility therapy on the prevalence of early gestational subclinical hypothyroidism (SCH) (TSH2 >2.5 mIU/L) and to evaluate implications on progression to clinical pregnancy (defined as detection of cardiac activity on ultrasound). METHODS: A retrospective chart review was performed in an academic fertility clinic on all patients with a measured pre-treatment TSH (TSH1) and positive beta-human chorionic gonadotropin following fertility treatment...
September 8, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28868522/primary-care-provider-management-of-congenital-hypothyroidism-identified-through-newborn-screening
#3
N A Rosenthal, E Bezar, S Mann, L K Bachrach, S Banerjee, M E Geffner, M Gottschalk, S K Shapira, L Hasegawa, L Feuchtbaum
OBJECTIVE: To assess Primary Congenital Hypothyroidism (CH) management patterns and feasibility of providing long-term care for patients with CH identified through newborn screening by Primary Care Providers (PCPs) in California and Hawaii. STUDY DESIGN: A survey was mailed to all physicians (N=823) listed as the referral doctor for confirmed patients with CH identified through newborn screening programs in both states between 01/01/2009-12/31/2013. Information was collected on CH management patterns, barriers to providing care, and knowledge on CH treatment...
2017: Ann Thyroid Res
https://www.readbyqxmd.com/read/28697689/vitamin-d-treatment-in-patients-with-hashimoto-s-thyroiditis-may-decrease-the-development-of-hypothyroidism
#4
Bekir Ucan, Mustafa Sahin, Muyesser Sayki Arslan, Nujen Colak Bozkurt, Muhammed Kizilgul, Askin Güngünes, Erman Cakal, Mustafa Ozbek
The relationship between Hashimoto's thyroiditis and vitamin D has been demonstrated in several studies. The aim of the present study was to evaluate vitamin D concentrations in patients with Hashimoto's thyroiditis, the effect of vitamin D therapy on the course of disease, and to determine changes in thyroid autoantibody status and cardiovascular risk after vitamin D therapy. We included 75 patients with Hashimoto's thyroiditis and 43 healthy individuals. Vitamin D deficiency is defined as a 25-hydroxy vitamin D (25(OH)D3) concentration less than 20ng/mL...
July 12, 2017: International Journal for Vitamin and Nutrition Research. Journal International de Vitaminologie et de Nutrition
https://www.readbyqxmd.com/read/28683860/latent-hypothyroidism-in-adults
#5
Jeannine Schübel, Joachim Feldkamp, Antje Bergmann, Wolfgang Drossard, Karen Voigt
BACKGROUND: The prevalence of latent/subclinical hypothyroidism is between 3% and 10%, according to epidemiologic studies that have been carried out in the USA, the United Kingdom, and Denmark. As persons with latent hypo - thyroidism are often asymptomatic, the diagnosis is often made incidentally in routine laboratory testing. METHODS: This review is based on a selective search in PubMed for publications on the diagnosis and treatment of latent hypothyroidism...
June 23, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28683242/targeted-levothyroxine-therapy-for-treatment-of-congenital-hypothyroidism
#6
Melissa J Schoelwer, Wanzhu Tu, Junyi Zhou, Erica A Eugster
OBJECTIVE: The purpose of this study was to determine if infants with congenital hypothyroidism (CH) whose initial dose of levothyroxine (LT4) is based on thyroid gland anatomy require fewer dose adjustments in the first six months of life than those who were started empirically on LT4. METHODS: Newborns with CH who had a thyroid ultrasound performed at diagnosis were eligible for this prospective, historical case-controlled study. The daily LT4 dose prescribed was based on results on the thyroid ultrasound as follows: 15 mcg/kg for athyreosis, 12 mcg/kg for a dysgenetic thyroid, and 10 mcg/kg for an anatomically normal gland...
July 6, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28670583/quality-of-life-among-family-caregivers-of-patients-on-hemodialysis-and-its-relevant-factors-a-systematic-review
#7
REVIEW
Seyedeh Azam Sajadi, Abbas Ebadi, Seyed Tayeb Moradian
BACKGROUND: Family caregivers are considered as hidden patients experiencing physical and mental disorders. This affects the quality of not only their lives but also the health care provided to patients.This study aimed to investigate the quality of life (QOL) and its related factors among the caregivers of patients undergoing hemodialysis. METHODS: This systematic review was conducted based on the eight-step guidelines presented by the York University. The databases relevant to the medical field including Nursing and Allied Health, Web of Science, Scopus, Pubmed, Embase, PsycINFO and Psychology Library were used...
July 2017: International Journal of Community Based Nursing and Midwifery
https://www.readbyqxmd.com/read/28661901/long-term-and-late-treatment-consequences-endocrine-and-metabolic-effects
#8
Thang S Han, Helena K Gleeson
PURPOSE OF REVIEW: Cancer therapies often result in the 'late effect of cancer treatment' whereby secondary health complications emerge years after radiotherapy and chemotherapy. This review focuses on endocrine and metabolic consequences in adult cancer survivors as late treatment effects. RECENT FINDINGS: Endocrine and metabolic disorders are among the most common late effects. Endocrine disorders include hypopituitarism, which leads to growth hormone deficiency, hypogonadism, adrenal insufficiency and hypothyroidism and related clinical manifestations...
September 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28572820/tsh-variability-of-patients-affected-by-differentiated-thyroid-cancer-treated-with-levothyroxine-liquid-solution-or-tablet-form
#9
Carlo Cappelli, Ilenia Pirola, Elena Gandossi, Claudio Casella, Davide Lombardi, Barbara Agosti, Fiorella Marini, Andrea Delbarba, Maurizio Castellano
BACKGROUND: Recent guidelines from the American Thyroid Association (ATA) indicate that, in many patients affected by differentiated thyroid cancer (DTC), the serum TSH should be maintained between 0.1 and 0.5 mU/L. The purpose of this study was to evaluate the TSH variability of patients affected by DTC treated with liquid L-T4 formulation or in tablet form. PATIENTS AND METHODS: Patients were eligible if (a) they were submitted to a total thyroidectomy and (131)I remnant ablation for DTC in our institution and (b) they were classified low-risk patients according to ATA guidelines 2009...
2017: International Journal of Endocrinology
https://www.readbyqxmd.com/read/28538388/myxedema-coma-a-case-report-of-pediatric-emergency-care
#10
Yueniu Zhu, Wenjuan Qiu, Mengyan Deng, Xiaodong Zhu
RAIONALE: Myxedema coma (MC) is extremely rare but lethal in pediatric patients with hypothyroidism leading to altered mental status and hypothermia. But there is no clinical guideline for such cases. PATIENT CONCERNS: A 6-year-old Chinese girl presented with coma and hypothermia preceded by pneumonia. Her lab results were: free thyroxin (T4) 4.18 pmol/L and thyroid-stimulating hormone (TSH) > 150 μIU/mL with extremely elevated anti-thyroid peroxidase (TPO-Ab) and anti-thyroglobulin...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28459030/the-thyroid-registry-clinical-and-hormonal-characteristics-of-adult-indian-patients-with-hypothyroidism
#11
Bipin Sethi, Sumitav Barua, M S Raghavendra, Jagdish Gotur, Deepak Khandelwal, Upal Vyas
OBJECTIVES: Appropriate treatment of hypothyroidism requires accurate diagnosis. This registry aimed to study the disease profile and treatment paradigm in hypothyroid patients in India. MATERIALS AND METHODS: We registered 1500 newly diagnosed, treatment-naïve, adult hypothyroid males and nonpregnant females across 33 centers and collected relevant data from medical records. The first analysis report on baseline data is presented here. RESULTS: The mean age of the study population was 41...
March 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28329380/subclinical-thyroid-dysfunction-and-cardiovascular-diseases-2016-update
#12
Carmen Floriani, Baris Gencer, Tinh-Hai Collet, Nicolas Rodondi
Subclinical thyroid dysfunction comprises subclinical hypothyroidism (SHypo), defined as elevated thyroid-stimulating hormone (TSH) by normal free thyroxine (FT4), and subclinical hyperthyroidism (SHyper) with decreased or undetectable TSH and normal FT4. Up to 10% of the elderly have SHypo, which is usually asymptomatic. Individual participant data (IPD) analyses of prospective cohort studies from the international Thyroid Studies Collaboration show that SHypo is associated with increased coronary heart disease (CHD) mortality [hazard ratio (HR) 1,58 for TSH ≥ 10 mIU/L, 95% CI 1...
February 27, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28328531/provider-variability-in-the-initial-diagnosis-and-treatment-of-congenital-hypothyroidism
#13
Luke Cielonko, Tyler Hamby, John S Dallas, Luke Hamilton, Don P Wilson
BACKGROUND: Early diagnosis and expeditious treatment of newborns with congenital hypothyroidism (CH) is necessary to avoid mental retardation. METHODS: A survey of 44 practitioners in the southern US was conducted to better understand common practices regarding neonatal CH and the findings were compared with current guidelines in the US and Europe. RESULTS: Responses indicated some consensus that 10-15 μg of thyroid hormone/kg/day was the appropriate dosage...
March 22, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28237002/congenital-hypothyroidism-role-of-nuclear-medicine
#14
REVIEW
Isabelle Keller-Petrot, Juliane Leger, Aline Sergent-Alaoui, Claire de Labriolle-Vaylet
Thyroid scintigraphy holds a key place in the etiologic workup of neonatal hypothyroidism. Routine screening for this disorder in maternity hospitals in industrialized countries, for nearly 40 years, has permitted early treatment and thereby helped to prevent its physical and mental complications. Neonatal hypothyroidism affects approximately 1 in 3000 births. The most common causes are abnormal thyroid gland development and defective hormone synthesis by an eutopic thyroid gland. The incidence of the latter has risen in recent years, for reasons that remain unclear...
March 2017: Seminars in Nuclear Medicine
https://www.readbyqxmd.com/read/28176629/congenital-hypothyroidism-facts-facets-therapy
#15
Yedukondalu Kollati, Ranga Rao Ambati, Prakash Narayana Reddy, N Satya Sampath Kumar, Rajesh K Patel, Vijaya R Dirisala
BACKGROUND: Thyroid hormone (T3) is essential for normal development of children enabling brain development and somatic growth. However, certain individuals are genetically predisposed with insufficient or no thyroid hormones. Such a condition is termed congenital hypothyroidism (CH). OBJECTIVE: In the present review, a brief back ground about congenital hypothyroidism, factors associated with CH leading to thyroid dysgenesis and thyroid dyshormonogenesis is elaborated...
2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28153744/thyroid-stimulating-hormone-tsh-%C3%A2-2-5mu-l-in-early-pregnancy-prevalence-and-subsequent-outcomes
#16
David M Carty, Flora Doogan, Paul Welsh, Anna F Dominiczak, Christian Delles
OBJECTIVE: There remains controversy over how women with abnormal thyroid function tests in pregnancy should be classified. In this study we assessed the proportion of women with thyroid stimulating hormone (TSH)≥2.5mU/l in a large obstetric cohort, and examined how many have gone on to develop thyroid disease in the years since their pregnancy. STUDY DESIGN: 4643 women were recruited and samples taken in early pregnancy between 2007 and 2010. Thyroid function tests were analysed in 2014; in women with raised TSH computerised health records and prescription databases were used to identify thyroid disease detected since pregnancy...
March 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28081173/effect-of-rifampin-on-thyroid-function-test-in-patients-on-levothyroxine-medication
#17
Hye In Kim, Tae Hyuk Kim, Hosu Kim, Young Nam Kim, Hye Won Jang, Jae Hoon Chung, Seong Mi Moon, Byung Woo Jhun, Hyun Lee, Won-Jung Koh, Sun Wook Kim
BACKGROUND: Levothyroxine (LT4) and rifampin (RIF) are sometimes used together; however, no clinical studies have assessed the effects of these drugs on thyroid function or the need to adjust LT4 dose. METHODS: We retrospectively reviewed the records of 71 Korean patients who started RIF during LT4 treatment. Clinically relevant cases that required dose adjustment according to the American Thyroid Association (ATA)/American Association of Clinical Endocrinologists (AACE) guidelines were identified, and risk factors of increased LT4 dose were analyzed...
2017: PloS One
https://www.readbyqxmd.com/read/27981511/the-emergence-of-levothyroxine-as-a-treatment-for-hypothyroidism
#18
REVIEW
James V Hennessey
OBJECTIVE: To describe the historical refinements, understanding of physiology and clinical outcomes observed with thyroid hormone replacement strategies. METHODS: A Medline search was initiated using the search terms, levothyroxine, thyroid hormone history, levothyroxine mono therapy, thyroid hormone replacement, combination LT4 therapy, levothyroxine Bioequivalence. Pertinent articles of interest were identified by title and where available abstract for further review...
January 2017: Endocrine
https://www.readbyqxmd.com/read/27892439/lichen-planus-pigmentosus-a-study-for-association-of-thyroid-dysfunction
#19
D Karn, S Kc, M Timalsina
Background Lichen planus pigmentosus (LPP) is considered a chronic and progressive variant of lichen planus. Although pigmentation occurs in the sun exposed areas, the etiology remains unknown and there are no appropriate treatment guidelines. Association with thyroid disorder has been described in various disorders of pigmentation. Objective The objective of this study was to find the association between LPP and thyroid dysfunction. Method A total of 54 clinically diagnosed cases of LPP and 54 age and sex matched healthy control volunteers were included in this case control study...
January 2016: Kathmandu University Medical Journal (KUMJ)
https://www.readbyqxmd.com/read/27790421/a-study-to-assess-the-validity-of-estimation-of-serum-ostase-level-in-hyperthyroid-and-hypothyroid-cases
#20
Polina Boruah, Arup Jyoti Baruah, Ranendra Hajong, Chandan Kumar Nath, Bhupen Barman, Happy Chutia, Kalyan Sarma
INTRODUCTION: One of the more specific assessments of the metabolic status of bone in normal and in disease conditions is the measurement of bone specific alkaline phosphatase or ostase. The measurement of serum ostase has several advantages over the measurements of other bone parameter. Because of its relatively long half-life, in-vivo (1 to 3days), it is relatively unaffected by diurnal variation. AIM: To find the correlation of serum ostase level in hyper and hypothyroid cases and also to study the validity of routine estimation of serum ostase in hyper and hypothyroid cases so as to monitor the base level bone health on presentation...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
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