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Diseases of the Thyroid pp 161–176Cite as

Problems in the Management of Hypothyroidism

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Part of the book series: Contemporary Endocrinology ((COE))

Abstract

Hypothyroidism is the most common endocrine deficiency state. Overt hypothyroidism affects 2% of adult women and 0.2% of adult men, and mild hypothyroidism is present in an additional 7–15% of older adults (1). The most common underlying cause is autoimmune (Hashimoto’s) thyroiditis, followed by previous thyroid radiation with 131I or external-beam therapy. Certain medications can cause hypothyroidism, particularly when given to patients with underlying autoimmune thyroiditis, including lithium carbonate, amiodarone, other iodine-containing compounds, the cytokines interferon (IFN)-α and interleukin (IL)-2, and the antithyroid thionamide drugs. Transient hypothyroidism occurs in forms of thyroiditis caused by presumptive viral infection (subacute thyroiditis) or autoimmunity (postpartum, painless, or silent thyroiditis). Congenital hypothyroidism (CH) caused by thyroid agenesis or defective hormonogenesis affects one in 4000 newborns. Rarely, hypothyroidism results from hypothalamic or pituitary disorders causing deficiencies in thyrotropin-releasing hormone (TRH) and thyroid-stimulating hormone (TSH, thyrotropin) respectively.

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References

  1. Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Arch Intern Med 2000;160:526–534.

    Article  PubMed  CAS  Google Scholar 

  2. Canaris GJ, Steiner JF, Ridgway EC. Do traditional symptoms of hypothyroidism correlate with biochemical disease? J Gen Intern Med 1997;12:544–550.

    Article  PubMed  CAS  Google Scholar 

  3. Ladenson PW, Singer PA, Levy EG, et al. American Thyroid Association Guidelines for Detection of Thyroid Dysfunction. Arch Intern Med 2000;160:1573–1575.

    Article  PubMed  CAS  Google Scholar 

  4. Surks MI, Chopra IJ, Mariash CN, Nicoloff JT, Solomon DH. American Thyroid Association guidelines for use of laboratory tests in thyroid disorders. JAMA 1990;263:1529–1532.

    Article  PubMed  CAS  Google Scholar 

  5. Ladenson PW. Diagnosis of Hypothyroidism. In: Braverman LE, Utiger RD, ed. The Thyroid: A Fundamental and Clinical Text. 8th ed. Lippincott Williams & Wilkins, Philadelphia, 2000, pp. 848–852.

    Google Scholar 

  6. Toft AD. Thyroxine therapy. N Engl J Med 1994;331:174–180.

    Article  PubMed  CAS  Google Scholar 

  7. Singer PA, Cooper DS, Levy KG, et al. Treatment guidelines for patients with hyperthyroidism and hypothyroidism. JAMA 1995;273:808–812.

    Article  PubMed  CAS  Google Scholar 

  8. Ross DS, Daniels GH, Gouveia D. The use and limitations of a chemiluminescent thyrotropin assay as a single thyroid function test in an out-patient endocrine clinic. J Clin Endocrinol Metab 1990;71:764–769.

    Article  PubMed  CAS  Google Scholar 

  9. Spencer CA, Takeuchi M, Kazarosyan M. Current status and performance goals for serum thyrotropin (TSH) assays. Clin Chem 1996;42:140–145.

    PubMed  CAS  Google Scholar 

  10. McDermott MT, Haugen BR, Lezotte DC, Seggelke S, Ridgway EC. Management practices among primary care physicians and thyroid specialists in the care of hypothyroid patients. Thyroid 2001;11,757–11,764

    Google Scholar 

  11. Fish LH, Schwartz HL, Cavanaugh J, Steffes MW, Bantle JP, Oppenheimer JH. Replacement dose, metabolism, and bioavailability of levothyroxine in the treatment of hypothyroidism. Role of triiodothyronine in pituitary feedback in humans. N Engl J Med 1987;26;316:764–770.

    Article  Google Scholar 

  12. Davis FB, LaMantia RS, Spaulding SW, Wehmann RE, Davis PJ. Estimation of a physiologic replacement dose of levothyroxine in elderly patients with hypothyroidism. Arch Intern Med 1984;144:1752–1754.

    Article  PubMed  CAS  Google Scholar 

  13. Ayala A, Danese MD, Ladenson PW. When to treat mild hypothyroidism. Clin Endocrinol Metab 2000;29: 399–416.

    Article  CAS  Google Scholar 

  14. Mandel SJ, Larsen PR, Seely EW, Brent GA. Increased need for thyroxine during pregnancy in women with primary hypothyroidism. N Engl J Med 1990;323:91–96.

    Article  PubMed  CAS  Google Scholar 

  15. Abramson J, Stagnaro-Green A. Thyroid antibodies and fetal loss: an evolving story. Thyroid 2001; 11:57–63.

    Article  PubMed  CAS  Google Scholar 

  16. Haddow JE, Palomaki GE, Allan WC, et al. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. N Engl J Med 1999;341:549–555.

    Article  PubMed  CAS  Google Scholar 

  17. Hays MT. Absorption of oral thyroxine in man. J Clin Endocrinol Metab 1968;28:749–756.

    Article  PubMed  CAS  Google Scholar 

  18. Azizi F, Belur R, Albano J. Malabsorption of thyroid hormones after jejunoileal bypass for obesity. Ann Intern Med 1979;90:941–942.

    PubMed  CAS  Google Scholar 

  19. Collins MT, Remaley AT, Csako G, et al. Increased levothyroxine requirements presenting as “inappropriate” TSH secretion syndrome in a patient with nephrotic syndrome. J Endocrinol Invest 2000;23:383–392.

    PubMed  CAS  Google Scholar 

  20. Surks MI, Sievert R. Drugs and thyroid function. N Engl J Med 1995;333:1688–1694.

    Article  PubMed  CAS  Google Scholar 

  21. Campbell NR, Hasinoff BB, Stalts H, Rao B, Wong NC. Ferrous sulfate reduces thyroxine efficacy in patients with hypothyroidism. Ann Intern Med 1992;15;117:1010–1013.

    Google Scholar 

  22. Singh N, Singh PN, Hershman JM. Effect of calcium carbonate on the absorption of levothyroxine. JAMA 2000;283:2822–2825.

    Article  PubMed  CAS  Google Scholar 

  23. Bell DS, Ovalle F. Use of soy protein supplement and resultant need for increased dose of levothyroxine. Endocr Pract 2001;7:193–194.

    PubMed  CAS  Google Scholar 

  24. Jabbar MA, Larrea J, Shaw RA. Abnormal thyroid function tests in infants with congenital hypothyroidism: the influence of soy-based formula. J Am Coll Nutr 1997;16:280–282.

    PubMed  CAS  Google Scholar 

  25. Liel Y, Harman-Boehm I, Shany S. Evidence for a clinically important adverse effect of fiber-enriched diet on the bioavailability of levothyroxine in adult hypothyroid patients. J Clin Endocrinol Metab 1996;81:857–859.

    Article  PubMed  CAS  Google Scholar 

  26. Chiu AC, Sherman SI. Effects of pharmacological fiber supplements on levothyroxine absorption. Thyroid 1998;8:667–671.

    Article  PubMed  CAS  Google Scholar 

  27. Shakir KMMM, Michaels RD, Hays JH, Potter BB. The use of bile acid sequestrants to lower serum thyroid hormones in iatrogenic hyperthyroidism. Ann Intern Med 1993;218:112–113.

    Google Scholar 

  28. Liel Y, Sperber AD, Shany S. Nonspecific intestinal adsorption of levothyroxine by aluminum hydroxide. Am J Med 1994;97:363–365.

    Article  PubMed  CAS  Google Scholar 

  29. Havrankova J, Lahaie R. Levothyroxine binding by sucralfate. Ann Intern Med 1992;117:445–446.

    PubMed  CAS  Google Scholar 

  30. Sherman SI, Tielens E, Ladenson PW. Sucralfate causes malabsorption of L-thyroxine. Am J Med 1994;96:531–535.

    Article  PubMed  CAS  Google Scholar 

  31. Oppenheimer JH, Bernstein G, Surks MI. Increase thyroxine turnover and thyroidal function after stimulation of hepatocellular binding of thyroxine by phenobarbital. J Clin Invest 1968;47:1399–1406.

    Article  PubMed  CAS  Google Scholar 

  32. Faba J, Lumholtz IB, Kirkegaard C, et al. The effects of phenytoin on the extrathyroidal turnover of thyroxine, 3,5,3′-triiodothyronine, 3,3′,5′-triiodothyronine, and 3′,5′-diiodothyronine in man. J Clin Endocrinol Metab 1985;6 1:1093–1099.

    Google Scholar 

  33. De Luca F, Arrigo T, Pandullo E, Siracusano MF, Benvenga S, Trimarchi F. Changes in thyroid function tests induced by 2 month carbamazepine treatment in L-thyroxine-substituted hypothyroid children. Eur J Pediatr 1986;145:77–79.

    Article  PubMed  Google Scholar 

  34. Isley WL. Effect of rifampin therapy on thyroid function tests in a hypothyroid patient on replacement L-thyroxine. Ann Intern Med 1987;107:517–518.

    PubMed  CAS  Google Scholar 

  35. Arafah BM. Increased need for thyroxine in women with hypothyroidism during estrogen therapy. N Engl J Med 2001;7;344:1743–1749.

    Article  Google Scholar 

  36. Arafah BM. Decreased levothyroxine requirement in women with hypothyroidism during androgen therapy for breast cancer. Ann Intern Med 1994;121:247–251.

    PubMed  CAS  Google Scholar 

  37. Stoffer SS, Szpunar WE. Potency of brand name and generic levothyroxine. JAMA 1980;244:1704–1705.

    Article  PubMed  CAS  Google Scholar 

  38. Ridgway EC. Interchangeability of levothyroxine preparations. Am J Med 1996;100:245–246.

    Article  PubMed  CAS  Google Scholar 

  39. Personal communication, Knoll Pharmaceutical Company, 2000.

    Google Scholar 

  40. Ferretti E, Persani L, Jaffrain-Rea ML, Giambona S, Tamburrano G, Beck-Peccoz P. Evaluation of the adequacy of levothyroxine replacement therapy in patients with central hypothyroidism. J Clin Endocrinol Metab 1999;84:924–929.

    Article  PubMed  CAS  Google Scholar 

  41. Pollock MA, Sturrock A, Marshall K, et al. Thyroxine treatment in patients with symptoms of hypothyroidism but thyroid function tests within the reference range: randomised double blind placebo controlled crossover trial. BMJ 2001;323:891–895.

    Article  PubMed  CAS  Google Scholar 

  42. Bunevicius R, Kazanavicius G, Zalinkevicius R, Prange AJ Jr. Effects of thyroxine as compared with thyroxine plus triiodothyronine in patients with hypothyroidism. N Engl J Med 1999;340:424–429.

    Article  PubMed  CAS  Google Scholar 

  43. Sawin CT, Geller A, Wolf PA, et al. Low serum thyrotropin concentrations as a risk factor for atrial fibrillation in older persons. N Engl J Med 1994;331:1249–1252.

    Article  PubMed  CAS  Google Scholar 

  44. Biondi B, Fazio S, Carella C, et al. Cardiac effects of long term thyrotropin-suppressive therapy with levothyroxine. J Clin Endocrinol Metab 1993;77:334–338.

    Article  PubMed  CAS  Google Scholar 

  45. Biondi B, Fazio S, Palmieri EA, et al. Left ventricular diastolic dysfunction in patients with subclinical hypothyroidism. J Clin Endocrinol Metab 1999;84:2064–2067.

    Article  PubMed  CAS  Google Scholar 

  46. Biondi B, Fazio S, Cuocolo A, et al. Impaired cardiac reserve and exercise capacity in patients receiving longterm thyrotropin suppressive therapy with levothyroxine. J Clin Endocrinol Metab 1996;81:4224–4228.

    Article  PubMed  CAS  Google Scholar 

  47. Fazio S, Biondi B, Carella C, et al. Diastolic dysfunction in patients on thyroid-stimulating hormone suppressive therapy with levothyroxine: beneficial effect of beta-blockade. J Clin Endocrinol Metab 1995; 80:2222–2226.

    Article  PubMed  CAS  Google Scholar 

  48. Biondi B, Fazio S, Carella C, et al. Control of adrenergic overactivity by beta-blockade improves the quality of life in patients receiving long term suppressive therapy with levothyroxine. J Clin Endocrinol Metab 1994;78:1028–1033.

    Article  PubMed  CAS  Google Scholar 

  49. Franklyn JA, Betteridge J, Daykin J, et al. Long-term thyroxine treatment and bone mineral density. Lancet 1992;340:9–13.

    Article  PubMed  CAS  Google Scholar 

  50. Quan ML, Pasieka JL, Rorstad O. Bone mineral density in well-differentiated thyroid cancer patients treated with suppressive thyroxine: a systematic overview of the literature. J Surg Oncol 2002;79:62–69.

    Article  PubMed  CAS  Google Scholar 

  51. Dillmann WH. Thyroid hormone influences on the cardiovascular system: molecular and clinical studies. Thyroid Today 2001;24:1–13.

    Google Scholar 

  52. Keating FR, Parkin TW, Sdby JB, Dickinson LS. Treatment of heart disease associated with myxedema. Prog Cardiovasc Dis 1961;3:364–381.

    PubMed  Google Scholar 

  53. Ellyin FM, Kumar Y, Somberg JC. Hypothyroidism complicated by angina pectoris: therapeutic approaches. J Clin Pharmacol 1992;32:843–847.

    PubMed  CAS  Google Scholar 

  54. Levine HD. Compromise therapy in the patient with angina pectoris and hypothyroidism. A clinical assessment. Am J Med 1980;69:411–418.

    Article  PubMed  CAS  Google Scholar 

  55. Danese MD, Ladenson PW, Meinert CL, Powe, NR. Effect of thyroxine therapy on serum lipoproteins in patients with mild thyroid failure: a quantitative review of the literature. J Clin Endocrinol Metab 2000; 85:2993–3001.

    Article  PubMed  CAS  Google Scholar 

  56. Hak AE, Pols HA, Visser TJ, Drexhage HA, Hofman A, Witteman JC. Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study. Ann Intern Med 2000;132:270–278.

    PubMed  CAS  Google Scholar 

  57. Perk M, O’Neill BJ. The effect of thyroid hormone therapy on angiographic coronary artery disease progression. Can J Cardiol 1997;13:273–276.

    PubMed  CAS  Google Scholar 

  58. Sherman SI, Ladenson PW. Percutaneous transluminal angioplasty in hypothyroidism. Am J Med 1991; 90:367–370.

    PubMed  CAS  Google Scholar 

  59. Ladenson PW, Levin AA, Ridgway EC, Daniels GH. Complications of surgery in hypothyroid patients. Am J Med 1984;77:261–266.

    Article  PubMed  CAS  Google Scholar 

  60. Bigos ST, Ridgway EC, Kourides IA, Maloof F. Spectrum of pituitary alterations with mild and severe thyroid impairment. J Clin Endocrinol Metab 1978;46:317–325.

    Article  PubMed  CAS  Google Scholar 

  61. Bush RK, Ehrlich EN, Reed CE. Thyroid disease and asthma. J Allergy Clin Immunol 1977;59:398–401.

    Article  PubMed  CAS  Google Scholar 

  62. Rowe MS, MacKechnie HLN. Hypothyroidism with coexisting asthma: problems in management. South Med J 1984;77:401–402.

    Article  PubMed  CAS  Google Scholar 

  63. Van Dop C, Conte FA, Koch TK, Clark SJ, Wilson-Davis SL, Grumbach MM. Pseudotumor cerebri associated with initiation of levothyroxine therapy for juvenile hypothyroidism. N Engl J Med 1983;308: 1076–1080.

    Article  PubMed  Google Scholar 

  64. Press OW, Ladenson PW. Pseudotumor cerebri and hypothyroidism. Arch Intern Med 1983;143:167–168.

    Article  PubMed  CAS  Google Scholar 

  65. Shakir KM, Turton D, Aprill BS, Drake AJ 3rd, Eisold JF. Anemia: a cause of intolerance to thyroxine sodium. Mayo Clin Proc 2000;75:189–192.

    PubMed  CAS  Google Scholar 

  66. Tunbridge WM, Vanderpump MP. Population screening for autoimmune thyroid disease. Endocrinol Metab Clin North Am 2000;29:239–253.

    Article  PubMed  CAS  Google Scholar 

  67. Hamblin PS, Dyer SA, Mohr VS, et al. Relationship between thyrotropin and thyroxine changes during recovery from severe hypothyroxinemia of critical illness. J Clin Endocrinol Metab 1986;62:717–722.

    Article  PubMed  CAS  Google Scholar 

  68. Lim VS. Thyroid function in patients with chronic renal failure. Am J Kidney Dis 2001;38 Suppl 1):S80–S84.

    Article  Google Scholar 

  69. Topliss DJ, White E, Stockigt JR. Significance of thyrotropin excess in untreated primary adrenal insufficiency. J Clin Endocrinol Metab 1980;S0:S2-S6.

    Google Scholar 

  70. Reed HL, Burman KD, Shakir KM, O’Brian JT. Alterations in the hypothalamic-pituitary-thyroid axis after prolonged residence in Antarctica. Clin Endocrinol (Oxf) 1986;25:55–65.

    Article  CAS  Google Scholar 

  71. Cooper DS. Clinical practice. Subclinical hypothyroidism. N Engl J Med 2001;345:260–265.

    Article  PubMed  CAS  Google Scholar 

  72. Vanderpump MP, Tunbridge WM, French JM, et al. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey. Clin Endocrinol (Oxf) 1995;43:55–68.

    Article  CAS  Google Scholar 

  73. Cooper DS, Halpern R, Wood LC, et al. L-thyroxine therapy in subclinical hypothyroidism. A double-blind, placebo controlled trial. Ann Intern Med 1984;101:18–24.

    PubMed  CAS  Google Scholar 

  74. Nystrom E, Caidahl K, Fager G et al. A double-blind, crossover, 12-month study of L-thyroxine treatment of women with “subclinical” hypothyroidism. Clin Endocrinol (Oxf) 1988;29:63–76.

    Article  CAS  Google Scholar 

  75. Jaeschke R, Guyatt G, Gerstein H, et al. Does treatment with L-thyroxine influence health status in middleaged and older adults with subclinical hypothyroidism? J Gen Intern Med 1996;11:744–749.

    Article  PubMed  CAS  Google Scholar 

  76. Meier C, Staub JJ, Roth CB, et al. TSH-controlled L-thyroxine therapy reduces cholesterol levels and clinical symptoms in subclinical hypothyroidism: a double blind, placebo-controlled trial (Basel Thyroid Study). J Clin Endocrinol Metab 2001;86:4860–4866.

    Article  PubMed  CAS  Google Scholar 

  77. Ridgway EC, Cooper DS, Walker H, Rodbard D, Maloof F. Peripheral responses to thyroid hormone before and after L-thyroxine therapy in patients with subclinical hypothyroidism. J Clin Endocrinol Metab 1981; 53:1238–1242.

    Article  PubMed  CAS  Google Scholar 

  78. Biondi B, Fazio S, Palmieri EA, et al. Left ventricular diastolic dysfunction in patients with subclinical hypothyroidism. J Clin Endocrinol Metab 1999;84:2064–2067.

    Article  PubMed  CAS  Google Scholar 

  79. Nicoloff JT, LoPresti JS. Myxedema coma. A form of decompensated hypothyroidism. Endocrinol Metab Clin North Am 1993;22:279–290.

    PubMed  CAS  Google Scholar 

  80. Jordan RM. Myxedema coma: pathophysiology, therapy, and factors affecting prognosis. Med Clin North Am 1995;79:185–194.

    PubMed  CAS  Google Scholar 

  81. McIver B, Gorman CA. Euthyroid sick syndrome: an overview. Thyroid 1997;7:125–132.

    Article  PubMed  CAS  Google Scholar 

  82. Holvey DN, Goodner CJ, Nicoloff JT, et al. Treatment of myxedema coma with intravenous thyroxine. Arch Intern Med 1964;113:139

    Article  Google Scholar 

  83. Pereira VG, Haron ES, Lima-Neto N, Medeiros-Neto GA. Management of myxedema coma: report on three successfully treated cases with nasogastric or intravenous administration of triiodothyronine. J Endocrinol Invest 1982;5:331–334.

    PubMed  CAS  Google Scholar 

  84. Ladenson PW, Ridgway EC. Early peripheral responses to intravenous L-thyroxine in primary hypothyroidism. Am J Med 1982;73:467–474.

    Article  PubMed  CAS  Google Scholar 

  85. Ladenson PW, Goldenheim PD, Ridgway EC. Rapid pituitary and peripheral tissue responses to intravenous L-triiodothyronine in hypothyroidism. J Clin Endocrinol Metab 1983;56:1252–1259.

    Article  PubMed  CAS  Google Scholar 

  86. Weinberg AD, Brennan MD, Gorman CA, Marsh HM, O’Fallon M. Outcome of anesthesia and surgery in hypothyroid patients. Arch Intern Med 1983;143:893–897.

    Article  PubMed  CAS  Google Scholar 

  87. Ladenson PW, Levin AA, Ridgway EC, Daniels GH. Complications of surgery in hypothyroid patients. Am J Med 1984;77:261–266.

    Article  PubMed  CAS  Google Scholar 

  88. Paine TD, Rogers WJ, Baxley WA, et al. Coronary arterial surgery in patients with incapacitating angina pectoris and myxedema. Am J Cardiol 1977;40:226–231.

    Article  PubMed  CAS  Google Scholar 

  89. Drucker DJ and Burrow GN. Cardiovascular surgery in the hypothyroid patient. Arch Intern Med 1985; 145:85–87.

    Article  Google Scholar 

  90. Braverman LE, Ingbar SH, Vagenakis AG, Adams L, Maloof F. Enhanced susceptibility to iodide myxedema in patients with Hashimoto’s disease. J Clin Endocrinol Metab 1971;32:515–521.

    Article  PubMed  CAS  Google Scholar 

  91. Matsuura N, Yamada Y, Nohara Y, et al. Familial neonatal transient hypothyroidism due to maternal TSHbinding inhibitor immunoglobulins. N Engl J Med 1980;303:738–741.

    Article  PubMed  CAS  Google Scholar 

  92. Sawers JS, Toft AD, Irvine WJ, Brown NS, Seth J. Transient hypothyroidism after iodine-131 treatment of thyrotoxicosis. J Clin Endocrinol Metab 1980;50:226–229.

    Article  PubMed  CAS  Google Scholar 

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  1. Paul W. Ladenson MD
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  1. Section of Endocrinology, Diabetes, and Nutrition, Boston Medical Center, Boston, MA, USA

    Lewis E. Braverman MD (Chief) (Chief)

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Ladenson, P.W. (2003). Problems in the Management of Hypothyroidism. In: Braverman, L.E. (eds) Diseases of the Thyroid. Contemporary Endocrinology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-352-1_8

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