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HYPOTHYROIDISM INVESTIGATION

Endocrinology

HYPOTHYROIDISM INVESTIGATION

1. High TSH + low free T4 => primary hypothyroidism.

2. High TSH + normal free T4 => subclinical hypothyroidism. Our understanding of this is still evolving. Studies indicate that patients with TSH 5-10mU/L will develop hypothyroidism at the rate of 4%/year. This increases with family hx of autoimmune thyroid disease and anti-TPO antibodies.

3. Low TSH + low free T4 => secondary/tertiary hypothyroidism. A/W deficiency of multiple hormones. Image the sella.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image:

1. High TSH + low free T4 => primary hypothyroidism.

2. High TSH + normal free T4 => subclinical hypothyroidism. Our understanding of this is still evolving. Studies indicate that patients with TSH 5-10mU/L will develop hypothyroidism at the rate of 4%/year. This increases with family hx of autoimmune thyroid disease and anti-TPO antibodies.

3. Low TSH + low free T4 => secondary/tertiary hypothyroidism. A/W deficiency of multiple hormones. Image the sella.

Ⓒ A. Manickam 2018

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