Clin Endocrinol (Oxf). 2015 May 23. doi: 10.1111/cen.12824. [Epub ahead of print]
Management of Primary Hypothyroidism Statement by the British Thyroid Association Executive Committee.
Okosieme O1, Gilbert J2, Abraham P3, Boelaert K4, Dayan C5, Gurnell M6, Leese G7, McCabe C8, Perros P9, Smith V8, Williams G10, Vanderpump M11.
1Prince Charles Hospital, Medicine, Merthyr Tydfil, United Kingdom.
2King's College Hospital, Endocrinology, Denmark Hill, London, United Kingdom.
3Aberdeen Royal Infirmary, Endocrinology, Foresterhill, Aberdeen, United Kingdom.
4University of Birmingham, Division of Medical Sciences, Birmingham, West Midlands, United Kingdom.
5Cardiff University, Centre for Endocrine and Diabetes Sciences, Cardiff, United Kingdom.
6Institute of Metabolic Science, Addenbrooke's Hospital, Endocrinology, Hills Road, Cambridge, United Kingdom.
7University of Dundee, Medical Research Institute, Dundee, United Kingdom.
8University of Birmingham, College of Medical and Dental Sciences, Birmingham, United Kingdom.
9Royal Victoria Infirmary, Endocrinology, Newcastle, United Kingdom.
10Imperial College London, Molecular Endocrinology Group, Department of Medicine, Hammersmith Campus, Du Cane Road, London, United Kingdom.
11Royal Free Hampstead NHS Trust, Endocrinology, Pond Street, London, United Kingdom.
Primary hypothyroidism is an insidious condition with a significant morbidity and often subtle and non-specific symptoms and clinical signs [1, 2]. The earliest biochemical abnormality is an increase in serum thyroid-stimulating hormone (thyrotrophin) (TSH) concentration associated with normal serum free thyroxine (T4) and triiodothyronine (T3) concentrations (subclinical hypothyroidism), followed by a decrease in serum free T4 concentration, at which stage most patients have symptoms and benefit from treatment (overt hypothyroidism) [1-3]. In the UK, the prevalence of spontaneous hypothyroidism is between 1% and 2%, and it is more common in older women and ten times more common in women than in men [4, 5]. The cause is either chronic autoimmune disease (atrophic autoimmune thyroiditis or goitrous autoimmune thyroiditis (Hashimoto's thyroiditis)) or destructive treatment for hyperthyroidism with either radioiodine or surgery which may account for up to one-third of cases of hypothyroidism in the community . Less frequent causes include surgery and radioiodine ablation for benign nodular thyroid disease and thyroid cancer, external beam irradiation of malignant tumours of the head and neck and drugs including lithium, amiodarone and interferon . Congenital hypothyroidism affects about one newborn in 3,500-4,000 births . This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
PMID: 26010808 [PubMed - as supplied by publisher]
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