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Pilz, S; Theiler-Schwetz, V; Malle, O; Steinberger, E; Trummer, C.
Hypothyroidism: guidelines, current knowledge, and clinical practice.
AUST J CLIN ENDOCR M. 2020; Doi: 10.1007/s41969-020-00114-9 [OPEN ACCESS]
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Leading authors Med Uni Graz: Pilz Stefan; Trummer Christian
Co-authors Med Uni Graz: Malle Oliver; Theiler-Schwetz Verena
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Abstract:: Hypothyroidism is present in about 5% of the population and is categorized into overt hypothyroidism with elevated thyroid-stimulating hormone (TSH) and reduced free thyroxine (fT4), and subclinical hypothyroidism with elevated TSH and fT4 within the normal range. Indications for TSH testing are not clearly defined but although general population screening is not recommended by most medical societies, overwhelming TSH testing is frequently observed in clinical routine. While overt hypothyroidism should be treated by thyroid hormone replacement, it is increasingly questioned whether subclinical hypothyroidism should be treated because symptoms that are usually attributed to hypothyroidism such as reduced quality of life, fatigue, or overweight are not significantly improved when treating patients with subclinical hypothyroidism. Interestingly, advances in our understanding of homeostasis and allostasis of thyroid function including individual setpoints and adaptive mechanisms may improve the diagnosis and therapy of hypothyroidism and might thus replace simple, linear TSH orientated approaches. In this brief review, we outline current guidelines regarding diagnostics and therapy of hypothyroidism in view of the current literature on this topic and pay particular attention to recommendations for clinical practice.
Find related publications in this database (Keywords): Thyroid; Thyroid malfunction; Thyroid hormone replacement; LT4; Recommendation