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http://www.onmedica.com/ClinicalArticleView.aspx?id=e5c5b5fb-516b-4f4d-9e1f-5b9a3d44ffde

The

management of hypothyroidism

Tillmann i, general practitioner, York. Reviewed by Luke

Koupparis, general practitioner, Bristol.

Tuesday, 21 February 2012

Key learning points

The development of hypothyroidism

can be complex and subtle.

A proportion of patients with

hypothyroidism in the UK may not be identified or treated adequately.

Measuring only TSH for diagnosis

can miss the rarer secondary or tertiary forms of hypothyroidism.

The development of a goitre is an

unreliable sign for hypothyroidism.

Some patients may not respond to

straightforward treatment with L-Thyroxine (T4) for physiological reasons

and therefore may need additional treatment.

The diagnosis and management of

subclinical hypothyroidism remains partially inconsistent or even

controversial, despite international expert advice.

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