ITEMS IN AFP WITH KEYWORD:
Thyroid and Parathyroid Disorders
Clinical hypothyroidism is present in one in 300 people in the United States, with higher prevalence in female and older patients. Common symptoms are cold intolerance, fatigue, weight gain, dry skin, constipation, and voice changes. The signs and symptoms that suggest thyroid dysfunction are nonspecific and nondiagnostic. A diagnosis is based on blood levels of thyroid-stimulating hormone and free thyroxine. There is no evidence that population screening is beneficial.
Sep 1, 2020 Issue
Treatment of Subclinical Hypothyroidism: BMJ Rapid Recommendation [Practice Guidelines]
Previous guidelines suggested that levothyroxine treatment may be appropriate with hypothyroid symptoms or a TSH level exceeding 10 mIU per L based on limited evidence. A recent large trial in older adults suggests that treatment shows no benefit in many areas and possible harm.
Over the past few years, molecular testing of fine-needle aspiration specimens has changed the way thyroid nodules with indeterminate cytology are managed. Find out which patients require molecular testing, who can be followed conservatively, and when to refer patients for surgery.
Key clinical questions and their evidence-based answers directly from the journal’s content, written by and for family physicians.
Oct 15, 2018 Issue
Morning vs. Evening Administration of Levothyroxine [FPIN's Clinical Inquiries]
The effectiveness of levothyroxine for reducing TSH levels is most dependent on the timing of meals in relation to drug administration. There is conflicting evidence. In two studies, levothyroxine taken at least two hours after eating in the evening maintained or improved TSH levels compared with morning administration.
A 45-year-old Korean American woman comes to your office for a wellness visit. She has a history of allergic rhinitis, and her family history is significant for diabetes mellitus in her father. She describes her health as good and has no concerns.
Mar 15, 2018 Issue
Screening for Thyroid Cancer: Recommendation Statement [U.S. Preventive Services Task Force]
The USPSTF recommends against screening for thyroid cancer in asymptomatic adults.
Treatment of patients with a minimally elevated thyrotropin (thyroid-stimulating hormone) level did not result in any improvement in symptoms. If patients present with a thyrotropin level between 4.6 and 10 mIU per L, repeat the test because the levels often normalize (this occurred in 60% of the patients initially referred for the study).
Learn about new research on the association between subclinical hyperthyroidism and the risk of cardiovascular disease and bone fractures.
Mar 1, 2017 Issue
Radioactive Iodine Therapy vs. Antithyroid Medications for Graves Disease [Cochrane for Clinicians]
Radioactive iodine therapy and antithyroid medications produce similar health-related quality-of-life outcomes in patients with Graves disease. Radioactive iodine therapy is an appropriate choice for patients who prefer definitive treatment.