Zealand, however, can be obtained via section 29* Combined use of liothyronine and levothyroxine is promoted on some It is not funded on the Pharmaceutical Schedule in New Liothyronine is a synthetic thyroid hormone which replaces T3. Levels within the normal reference range. 3 It is characterised by TSH lower than the reference range but FT4 and FT3 Subclinical hyperthyroidism affects approximately 2% of adults and increases with advancing age with 3% of adults overĨ0 years of age being affected. Thyrotoxic crisis, atrial fibrillation, loss of bone mass and congestive heart failure. 8 Complications include Graves’ opthalmopathy, Reference range and FT4 and/or FT3 levels above the normal reference range. Overt hyperthyroidism affects 1.9% of women and 0.16% of men and is characterised by a TSH level lower than the Patients with subclinical hypothyroidism may 4 It is characterised by a TSH concentration that is increasedĪbove the reference range but FT4 concentration within the normal range. Women over 60 years of age have elevated TSH levels. Subclinical hypothyroidism affects women more than men and occurs more frequently with increasing age - up to 10% of Occurring in elderly people with undiagnosed disease or in patients who are poorly compliant with treatment. 7 Myxoedema coma is a rare complication of hypothyroidism most often Untreated overt hypothyroidism can cause fatigue, weight gain, abnormal lipid profile, heart failure, and, in children,Ĭan retard growth and mental development. Overt hypothyroidism affects approximately 1-2% of women and 0.1% of men and is characterised by a TSH concentrationĪbove the normal reference range and a FT4 concentration below the reference range. Thyroid dysfunction can be classified as overt or subclinical Graves disease have TPO antibodies, usually at high levels, although they are also found in a small number of people who Almost all people with autoimmune hypothyroidism and up to 80% of those with Thyroid disease by approximately two-fold. In subclinical disease, the presence of TPO-Ab increases the long-term risk of progression to clinically significant TPO antibodies are a risk factor for autoimmune thyroidĭisorders. TPOĪntibodies were previously referred to as microsomal antibodies. “Thyroid antibodies” is a non specific term thatĮncompasses the tests for thyroid peroxidase antibodies (TPO-Ab) and the less common anti-thyroglobulin antibodies. Those with a history of postpartum thyroiditis Those who have had radiotherapy to the neck for head and neck cancer Those who have had treatment with radioactive iodine therapy or surgery for hyperthyroidism Those with a genetic condition such as Down or Turner syndromes type 1 diabetes, Addison’s disease, coeliac disease Those with other autoimmune disease, e.g. Table 2: People who may be at increased risk of hypothyroidism (adapted from Vaidya, 2008) 5 People every one to two years or if there are symptoms or signs of thyroid disease. Specific groups of people are at higher risk of developing hypothyroidism (Table 2) and some recommend screening these To include relevant clinical details and medications on the request form. (“reflex” testing) or the additional tests may be added by the clinician. Most laboratories do this automatically following an abnormal TSH result 6 Ifįurther tests, such as serum free thyroxine (FT4), free triiodothyronine (FT3) or thyroid antibodies ( seeīelow) are required following an abnormal TSH result, these may be added to the original request without the needįor the patient to have a second blood test. In most situations serum thyroid stimulating hormone (TSH) can be used as the initial measure of thyroid function. TSH can be used as the initial measure of thyroid function in most cases
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