Interval between tests and thyroxine estimation method influence outcome of monitoring of subclinical hypothyroidism.
نویسندگان
چکیده
CONTEXT/OBJECTIVE Most patients with subclinical hypothyroidism are regularly monitored when treatment is not started. We have studied how interval between follow-up visits and how different T(4) estimates influence diagnostic outcome in a cohort of patients with untreated subclinical hypothyroidism, and studied whether assessment of clinical symptoms and signs aids evaluation of an individual subclinical hypothyroidism patient. DESIGN/PATIENTS During 1 yr, monthly measurements of TSH and three different T(4) estimates, and recording of hypothyroid symptoms and signs were performed in 21 patients with subclinical hypothyroidism confirmed on two occasions 3 months apart. RESULTS One patient was euthyroid at all visits, and one started treatment for profound overt hypothyroidism. The remaining patients were subclinical hypothyroidism at 74%, overtly hypothyroid at 22%, and had normal thyroid function tests in 4% of the visits. Increasing frequency of visits associated significantly with decreasing number of patients characterized as subclinical hypothyroidism after 1 yr (P = 0.016). Diagnosis of overt hypothyroidism differed between T(4) estimates (P = 0.005) and was highly dependent on T(4) reference limits. The hypothyroid clinical score did not differ between biochemical diagnoses (P = 0.29). CONCLUSIONS The monitoring procedure itself may influence the outcome of control of subclinical hypothyroidism. Specifically, the interval between visits, type of T(4) estimate used, and lower T(4) reference limit influenced the outcome when untreated subclinical hypothyroidism patients were followed for 1 yr. The hypothyroid clinical score did not aid the evaluation in individual subclinical hypothyroidism patients.
منابع مشابه
Variation in thyroid function in subclinical hypothyroidism: importance of clinical follow-up and therapy.
Subclinical hypothyroidism (SCH) is a common condition that is often observed without therapy. However, no evidence-based recommendation exists with regards to how patients with untreated SCH should be monitored. Monitoring involves regular assessment of symptoms and signs of hypothyroidism (HYPO) and biochemical tests of thyroid function. An important question when repeated tests of thyroid fu...
متن کاملCorrelation Between Subclinical Hypothyroidism and Dyslipidemia
Background & Objective: Thyroid hormones have an important role in the regulation of lipid metabolism. Subclinical hypothyroidism (SCH), defined as a mild increase in thyroid-stimulating hormone (TSH) and normal level of thyroxine (T4), could be associated with altered lipid profile. The current study aimed at assessing the association between SCH and ...
متن کاملفراوانی کم کاری تیروئید در بیماران دیابتی نوع یک زیر 16 سال
Background and purpose: Diabetes mellitus is the most common endocrinologic disease in children and adolescents. Type 1 diabetes mellitus (T1DM) is frequently associated with autoimmune thyroid disease. It is believed that the prevalence of thyroid disease in T1DM patients is higher than normal population. Various studies reported the incidence of hypothyroidism as 2-32% in T1DM. This study inv...
متن کاملVariation in thyroid function tests in patients with stable untreated subclinical hypothyroidism.
OBJECTIVE Knowledge of variation in thyroid function is important for interpretation of thyroid function tests. We aimed to describe intra-individual variation in thyroid function in patients with stable, untreated subclinical hypothyroidism (SCH) compared to euthyroid individuals to assess the importance of monitoring SCH patients. DESIGN We measured thyrotropin (TSH), free thyroxine (fT4), ...
متن کاملاثرات درمان با لووتیروکسین بر جنبههای شناختی و افسردگی در مبتلایان به کمکاری تحت بالینی تیرویید: کارآزمایی بالینی دو سوکور
Background & Objective: Subclinical hypothyroidism is defined by an increased serum TSH(Thyroid Stimulating Hormone) level in the presence of normal concentrations of circulating thyroid hormones and may be a predisposing factor for depression and psychomotor disorders. The aim of this study was to evaluate the effcts of L-thyroxine replacement on anxiety, depression and other neuropsychiat...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- The Journal of clinical endocrinology and metabolism
دوره 93 5 شماره
صفحات -
تاریخ انتشار 2008