+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Diagnosis and therapy of hypothyroidism in adulthood

Diagnosis and therapy of hypothyroidism in adulthood

Zeitschrift für Arztliche Fortbildung 90(1): 43-49

In the majority of cases, the symptoms of hypothyroidism develop slowly and as a result, they often are not recognized or misjudged for a long time. The complete picture is a late diagnosis. Especially in older patients, the symptoms are quite frequently assigned to the aging process. The most important form is the primary hypothyroidism often caused by auto-immune thyroiditis. The presence of a hypothyroidism should be considered more often and a TSH examination should be run. Normal TSH levels exclude a primary hypothyroidism. Increased TSH levels in conjunction with lowered T4 levels prove the diagnosis. If a secondary form is suspected, complete pituitary diagnostics are mandatory. The substitution therapy is carried out with a medium dosage of levothyroxine, 2.0 micrograms/kg body weight per day. The appropriate dosage should be established slowly using small initial dosages. This is especially important in older patients and in those suffering from coronary disorders. For younger patients and those with a shorter history, a more immediate adjustment is possible. During gravidity, the hormone requirement increasing by 40% must be taken into consideration. The therapeutic effect is shown by the clinic as well as by the TSH level. Overdosage will lead to a reversible appearance of thyreoitoxicosis factitia and require re-adjustment of the dosage. A physiological dosage does not have negative consequences on the bone metabolism. Transitory corrections are possible although a continuous substitution is necessary most of the time. Regular checks must be made as the therapy may be discontinued in 40% of the cases. In case of subclinical hypothyroidism, an indication for treatment does not exist in all patients. However, treatment is indicated if there is a high risk for developing a permanent form of hypothyroidism or if additional findings exist possibly linked to subclinical hypothyroidism. This would make a hormone substitution necessary. In case of doubt, a probatory therapy can be initiated and discontinued after 6-12 months when there is no therapeutic effect.

Please choose payment method:

(PDF emailed within 1 workday: $29.90)

Accession: 045768230

Download citation: RISBibTeXText

PMID: 8650962

Related references

Diagnosis and treatment guideline for primary hypothyroidism in adulthood. Revista Medica del Instituto Mexicano del Seguro Social 50(1): 71-80, 2012

Hashimoto's disease; diagnosis and therapy of hypothyroidism and reversible hypothyroidism. Nihon Naika Gakkai Zasshi. Journal of the Japanese Society of Internal Medicine 86(7): 1147-1155, 1997

Enzyme defects of the urea cycle in differential acute encephalopathy diagnosis in adulthood. Diagnosis and current therapy concepts. Der Nervenarzt 70(2): 111-118, 1999

Hypopituitarism in adulthood: diagnosis and therapy. Medizinische Klinik 104(3): 225-234, 2009

Diagnosis and therapy of hypothyroidism. Die Medizinische Welt 29(26): 1080-1084, 1978

Hypothyroidism--diagnosis and therapy. Mmw Fortschritte der Medizin 152(44): 67-9, 71; Quiz 72, 2011

Diagnosis and therapy of hypophyseal hypothyroidism. Zeitschrift für Klinische Medizin 156(1): 87-93, 1959

Diagnosis and therapy of hypothyroidism in children. Pediatricke Listy 8(5): 252-256, 1953

Hypothyroidism in children: its diagnosis and therapy. Nihon Rinsho. Japanese Journal of Clinical Medicine 32(7): 2371-2375, 1974

Diagnosis and therapy of celiac disease in adolescence and adulthood. Zeitschrift für Gastroenterologie 40(7): I-Vii, 2002

Hypothyroidism in adulthood. Zeitschrift für Arztliche Fortbildung 83(10): 507-511, 1989

Early diagnosis and therapy of connatal hypothyroidism. Deutsche Medizinische Wochenschrift 103(19): 801-802, 1978

Current aspects in the diagnosis and therapy of hypothyroidism. Zeitschrift für die Gesamte Innere Medizin und Ihre Grenzgebiete 32(8): 117-120, 1977

Clinical diagnosis and therapy of hypothyroidism in dogs. Journal of the American Veterinary Medical Association 140: 341-347, 1962

Hermaphroditism verus: clinical aspects, diagnosis and therapy in adulthood. Geburtshilfe und Frauenheilkunde 53(5): 356-358, 1993