Treatment-refractory hypothyroidism
| Autor: | Laura J McNally, Samson O Oyibo, Catherine I Ofiaeli |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
endocrine system
Pediatrics medicine.medical_specialty endocrine system diseases Levothyroxine Thyrotropin Reference range 030204 cardiovascular system & hematology Intestinal absorption Medication Adherence 03 medical and health sciences 0302 clinical medicine Hypothyroidism Thyroid-stimulating hormone medicine Humans Blood test 030212 general & internal medicine Referral and Consultation Fatigue medicine.diagnostic_test Treatment refractory business.industry Thyroid Disease Management General Medicine Thyroxine medicine.anatomical_structure Intestinal Absorption business Hormone medicine.drug |
| Zdroj: | BMJ. :l579 |
| ISSN: | 1756-1833 0959-8138 |
| Popis: | What you need to know A 40 year old woman complains of tiredness over the past few weeks. She had a total thyroidectomy three years ago for Graves’ thyrotoxicosis and has been taking levothyroxine since then. She weighs 80 kg and is taking 150 μg daily. A blood test done in the previous week showed thyroid stimulating hormone (TSH) levels above 30 mU/L (reference range 0.4-4.5 mU/L). Some hypothyroid patients continue to have symptoms or biochemical evidence of hypothyroidism (serum TSH above the upper laboratory reference range) despite standard thyroid replacement therapy. The prevalence of treatment-refractory hypothyroidism is not established. Studies in different populations report about a third of patients taking thyroid medications have TSH levels above the reference range, suggesting inadequate thyroid hormone replacement.12 Further dose increase may not always be appropriate. Patients may not be taking the treatment regularly as advised. Conditions that decrease absorption or increase demand … |
| Databáze: | OpenAIRE |
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