Hypothyroidism: clinical presentation, diagnosis, treatment
DOI:
https://doi.org/10.12775/JEHS.2022.12.08.067Keywords
hypothyroidism, thyroid disease, levothyroxine, tsh, thyroid, thyroid hormonesAbstract
Introduction and purpose:
Hypothyroidism is a common disorder of the endocrine system in which the thyroid gland is not able to produce enough of certain thyroid hormones.
Brief description of the state of knowledge:
The prevalence of hypothyroidism is between 1 and 6% and it is more common in women and older adults. Untreated significantly decreases the quality of life and increases mortality. Symptoms of hypothyroidism are nonspecific and may be confused with signs of other clinical conditions. The most common symptoms are chronic tiredness and fatigue, weight gain, cold intolerance, dry skin and hair loss. Serum thyroid-stimulating hormone (TSH) is the primary screening test for thyroid disfunction. Standard treatment for hypothyroidism consists of thyroid hormone replacement called levothyroxine.
Conclusion:
This article reviews basic informations, clinical presentation, diagnosis and treatment of hypothyroidism.
References
Lewiński. A. Niedoczynność tarczycy, Interna Szczeklika 2018, Kraków, Medycyna Praktyczna; 2018, pp. 1327-1334.
Chaker L, Bianco AC, Jonklaas J, Peeters RP. Hypothyroidism. Lancet. 2017 Sep 23;390(10101):1550-1562. doi: 10.1016/S0140-6736(17)30703-1. Epub 2017 Mar 20. PMID: 28336049; PMCID: PMC6619426.
Carlé A, Pedersen IB, Knudsen N, et al. Hypothyroid symptoms fail to predict thyroid insufficiency in old people: a population-based case-control study. Am J Med 2016; 129: 1082–92.
Carlé A, Pedersen IB, Knudsen N, Perrild H, Ovesen L, Laurberg P. Hypothyroid symptoms and the likelihood of overt thyroid failure: a population-based case-control study. Eur J Endocrinol 2014; 171: 593–602
Gietka-Czernel M.: Niedoczynność tarczycy. W: Zgliczyński W. red. Endokrynologia cz. I, Wyd. I. Wyd. Medical Tribune Polska, Warszawa 2011
Patil N, Rehman A, Jialal I. Hypothyroidism. [Updated 2022 Jun 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022
Szwajkosz Katarzyna, Zwolak Agnieszka, Dudzińska Marta, Świrska Joanna, Oszywa-Chabros Anna, Wawryniuk Agnieszka, Łuczyk Robert, Daniluk Jadwiga. Nadwaga i otyłość a niedoczynność tarczycy= Overweight and obesity in hypothyroidism. Journal of Education, Health and Sport. 2016;6(7):419-428. eISSN 2391-8306.
Udovcic M, Pena RH, Patham B, Tabatabai L, Kansara A. Hypothyroidism and the Heart. Methodist Debakey Cardiovasc J. 2017 Apr-Jun;13(2):55-59. doi: 10.14797/mdcj-13-2-55. PMID: 28740582; PMCID: PMC5512679.
Kim TH, Kim KW, Ahn HY, et al. Effect of seasonal changes on the transition between subclinical hypothyroid and euthyroid status. J Clin Endocrinol Metab 2013; 98: 3420–29.
Garber JR, Cobin RH, Gharib H, et al. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and The American Thyroid Asocciation. Endocr Pract 2012;8:1-45.
Mechanick JI, Camacho PM, Cobin RH, et al. American Association of Clinical Endocrinologists protocol for standarized production of clinical practice guidelines – 2010 update. Endocr Pract 2010;6:270-83
C.A. Spencer, J.S. LoPresti, A. Patel, et al.Applications of a new chemiluminometric thyrotropin assay to subnormal measurementJ Clin Endocrinol Metab, 70 (1990), pp. 453-460
Ambroziak, U. (2013). Wytyczne postępowania w niedoczynności tarczycy u dorosłych. Medycyna po Dyplomie, 3, 17-19.
Esfandiari NH, Papaleontiou M. Biochemical Testing in Thyroid Disorders. Endocrinol Metab Clin North Am. 2017 Sep;46(3):631-648. doi: 10.1016/j.ecl.2017.04.002. Epub 2017 Jun 8. PMID: 28760230; PMCID: PMC5957513.
LeFevre, Michael L., and US Preventive Services Task Force*. "Screening for thyroid dysfunction: US Preventive Services Task Force recommendation statement." Annals of internal medicine 162.9 (2015): 641-650.
Garber JR, Cobin RH, Gharib H, Hennessey JV, Klein I, Mechanick JI, Pessah-Pollack R, Singer PA, Woeber KA; American Association Of Clinical Endocrinologists And American Thyroid Association Taskforce On Hypothyroidism In Adults. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Thyroid. 2012 Dec;22(12):1200-35. doi: 10.1089/thy.2012.0205. Epub 2012 Nov 6. Erratum in: Thyroid. 2013 Feb;23(2):251. Erratum in: Thyroid. 2013 Jan;23(1):129. PMID: 22954017.
Szczepanek-Parulska E, Hernik A, Ruchała M. Anemia in thyroid diseases. Pol Arch Intern Med. 2017 May 31;127(5):352-360. doi: 10.20452/pamw.3985. Epub 2017 Mar 28. PMID: 28400547.
McGrowder D A, Fraser Y P, Gordon L, Crawford T V, Rawlins J M. Serum creatine kinase and lactate dehydrogenase activities in patients with thyroid disorders. Niger J Clin Pract 2011;14:454-9
Liamis, G., Filippatos, T. D., Liontos, A., & Elisaf, M. S. (2017). MANAGEMENT OF ENDOCRINE DISEASE: Hypothyroidism-associated hyponatremia: mechanisms, implications and treatment, European Journal of Endocrinology, 176(1), R15-R20. Retrieved Aug 7, 2022, from https://eje.bioscientifica.com/view/journals/eje/176/1/R15.xml
Jonklaas J, Bianco AC, Bauer AJ, Burman KD, Cappola AR, Celi FS, Cooper DS, Kim BW, Peeters RP, Rosenthal MS, Sawka AM; American Thyroid Association Task Force on Thyroid Hormone Replacement. Guidelines for the treatment of hypothyroidism: prepared by the american thyroid association task force on thyroid hormone replacement. Thyroid. 2014 Dec;24(12):1670-751. doi: 10.1089/thy.2014.0028. PMID: 25266247; PMCID: PMC4267409.
R. Negro, A. Schwartz, R. Gismondi, A. Tinelli, T. Mangieri, A. Stagnaro-Green Increased pregnancy loss rate in thyroid antibody negative women with TSH levels between 2.5 and 5.0 in the first trimester of pregnancy
Bolk N., Visser T.J., Nijman J., Jongste I.J., Tijssen J.G., Berghout A. Effects of evening vs morning levothyroxine intake: a randomized double-blind crossover trial. Arch Intern Med. 2010; 170: 1996-2003
Bach-Huynh TG, Nayak B, Loh J, Soldin S, Jonklaas J. Timing of levothyroxine administration affects serum thyrotropin concentration. J Clin Endocrinol Metab 2009;94:3905-12. Epub July 7, 2009
Hueston WJ. Treatment of hypothyroidism. Am Fam Physician. 2001 Nov 15;64(10):1717-24. Erratum in: Am Fam Physician 2002 Jun 15;65(12):2438. PMID: 11759078.
Singer PA, Cooper DS, Levy EG, Ladenson PW, Braverman LE, Daniels G, et al. Treatment guidelines for patients with hyperthyroidism and hypothyroidism. Standards of Care Committee, American Thyroid Association. JAMA. 1995;273:808-12.
Ruggeri RM, Trimarchi F, Biondi B. L-thyroxine replacement therapy in the frail elderly: a challenge in clinical practice. Eur J Endocrinol 2017; 177: R199-217.
Rizzo LFL, Mana DL. Treatment of hypothyroidism in special situations. Medicina (B Aires). 2020;80 Suppl 6:83-93. English. PMID: 33481737.
Sahay RK, Nagesh VS. Hypothyroidism in pregnancy. Indian J Endocrinol Metab. 2012 May;16(3):364-70. doi: 10.4103/2230-8210.95667. PMID: 22629500; PMCID: PMC3354841.
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Copyright (c) 2022 Dominika Wojtachnio, Aleksandra Osiejewska, Jakub Bartoszewicz, Anna Grądzik, Izabela Nowakowska, Małgorzata Kudan, Anna Gorajek, Karolina Mikut
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