Hypothyroidism — Treatment Issues: Towards an Indian Consensus

Hypothyroidism was the first endocrine disorder treated by replacement with the deficient hormone, in the form of extracts of animal thyroid glands. Subsequently, the development of purified thyroid hormone preparations and greater understanding of thyroid physiology have made it possible to mimic the function of the normal thyroid gland with thyroid hormone replacement therapy. Thyroid hormone therapy is safe and well tolerated by most patients, and many patients can be treated for prolonged periods with little change in dosage. However, several clinical situations and drugs can alter the absorption, metabolism, and action of exogenous thyroid hormone and therefore may necessitate adjustment of therapy. The range of dose preparations that are available, and the ability of monitor therapy with measurements of serum thyrotropin (TSH) allow the clinician to provide adequate therapy while minimizing both overand undertreatment.