Management of Primary Hypothyroidism Statement by the British Thyroid Association Executive Committee.
File(s)
Author(s)
Type
Journal Article
Abstract
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 [6]. 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 [1]. Congenital hypothyroidism affects about one newborn in 3,500-4,000 births [7]. This article is protected by copyright. All rights reserved.
Date Issued
2015-05-23
Date Acceptance
2015-05-18
Citation
Clinical Endocrinology, 2015, 84 (6), pp.799-808
ISSN
1365-2265
Publisher
Wiley
Start Page
799
End Page
808
Journal / Book Title
Clinical Endocrinology
Volume
84
Issue
6
Copyright Statement
© 2015 John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Okosieme, O., Gilbert, J., Abraham, P., Boelaert, K., Dayan, C., Gurnell, M., Leese, G., McCabe, C., Perros, P., Smith, V., Williams, G. and Vanderpump, M. (2015), Management of primary hypothyroidism: statement by the British Thyroid Association Executive Committee. Clin Endocrinol. doi:10.1111/cen.12824, which has been published in final form at https://dx.doi.org/10.1111/cen.12824. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving (http://olabout.wiley.com/WileyCDA/Section/id-820227.html#terms).
Subjects
Endocrinology & Metabolism
1103 Clinical Sciences
1114 Paediatrics And Reproductive Medicine
Publication Status
Published