HYPOTHYROIDISM: COMMON MISTAKES IN THE PRACTICE OF INTERNIST
- Authors: Fadeev V.V.1, Manuilova Y.A.1
-
Affiliations:
- I.M. Sechenov First Moscow State Medical University
- Issue: No 4 (2015)
- Pages: 63-70
- Section: Articles
- URL: https://journals.eco-vector.com/2412-4036/article/view/277349
- ID: 277349
Cite item
Open Access
Access granted
Abstract
Hypothyroidism, despite the high prevalence, easy diagnosis, a well-known and simple algorithm for the treatment, is accompanied by a high percentage of decompensated patients that can be associated with a wide variety of causes. According to various authors, both foreign and Russian, their share is 20-40%. The reasons for considering the low compliance of patients, their psychological state (in particular, depression), change of the brand of levothyroxine, accompanying chronic diseases (e.g., atrophic gastritis and celiac disease) and inadequate recommendations. Various measures to overcome these reasons are offered including the establishment of registers of patients with active mandatory supervision, the accounting quantity of the accepted pills, consult a psychologist for the correction of psycho-emotional disorders, assessment of bioavailability of levothyroxine after the change of the brand. This article describes the main mistakes therapists and endocrinologists committed in the diagnosis and treatment of hypothyroidism.
Full Text
About the authors
Valentin Viktorovich Fadeev
I.M. Sechenov First Moscow State Medical University
Email: walfad@mail.ru
MD, Professor, Head of the Department of Endocrinology 119121, Moscow, 1, bld 1/2. Pogodinskaya St
Yuliya Aleksandrovna Manuilova
I.M. Sechenov First Moscow State Medical UniversityPhD, endocrinologist, Department of Endocrinology 119121, Moscow, 1, bld 1/2. Pogodinskaya St
References
- Canaris G., Manowitz N., Mayor G. The Colorado thyroid disease prevalence study. Arch. Internal. Medicine. 2000;160:526-34.
- Parle J., Franclyn J., Cross K., Jones S., Sheppard M. Prevalence and follow-up of abnormal TSH concentration in the elderly in the UK. Clin. Endocrinology (Oxford). 1991;34(1):77-83.
- Frey H., Johannesen O., Kapelrad H. Appropriate replacement dose of thyroxine in primary hypothyroidism. Acta. Mad. Scand. 1987;222:163-7.
- Leese G., Jung R., Scott A. Long-term follow-up of treated hyperthyroid and hypothyroid patients. Health Bull. 1993;51(3):177-83.
- Garber J.R., Cobin R.H., Gharib H., Hennessey J.V., Klein I., Mechanick J.I., Pessah-Pollack R, Singer P.A., Woeber K.A. Clinical practice guidelines for hypothyroidism in adults: co-sponsored by the American Association of Clinical Endocrinologist and the American Thyroid Association. Endocr. Pract. 2012;1 1:1-207.
- Pearce B.G., Duntas L., Monzani F., Peeters R., Razvi S., Wemeau J-L. 2013 ETA guideline: management of subclinical hypothyroidism. Eur. Thyroid. J. 2013;2:215-28.
- Lazarus J., Brown R.S., Daumerie C., Hubalewska-Dydejczyk A., Negro R., Vaidya B. 2014 European thyroid association guidelines for the management of subclinical hypothyroidism in pregnancy and in children. Eur. Thyroid. J. 2014;3:76-94.
- Mandel S., Brent G., Larsen P. Levothyroxine therapy in patients with thyroid desease. Ann. Intern. Med. 1993;119:492-502.
- Saravanan P., Visser T.J., Dayan C.M. Psychological well-being in patient on «adequate» doses of L-thyroxine. Clin. Endocr. 2002;57(5):577-85.
- Chakera A.J., Pearce S.H., Vaidya B. Treatment for primary hypothyroidism: current approaches and future possibilities. Drug Des. Devel. Ther. 2012;6:1-11.
- Wiersinga W.M., Duntas L., Fadeyev V., Nygaard B., Vanderpump M. The use of LT4+LT3 in the treatment of hypothyroidism: guidelines of the European Thyroid Association. Eur. Thyroid J. 2012;1(2):55-71.
- Jonklaas J., Bianco A.C., Bauer A.J., Burman K.D., Cappola A.R., Celi F.S., Cooper D.S., Kim B.W., Peeters R.P., Rosenthal M.S., Sawka A.M. Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association task force on thyroid hormone replacement. Thyroid. 2014;24(12):1670-751.
Supplementary files
