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In addition to recognizing subtle clinical signs of hypothyroidism—fatigue, decreased energy, and other non-specific findings—what are the guideline-consistent benchmarks for laboratory evaluation of a person suspected of having hypothyroidism?

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In addition to recognizing subtle clinical signs of hypothyroidism—fatigue, decreased energy, and other non-specific findings—what are the guideline-consistent benchmarks for laboratory evaluation of a person suspected of having hypothyroidism?

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CMEducation Resources IQ&A Thyroid Hormone Replacement Medical Intelligence Zone

Presenter

Antonio Bianco, MD, PhD

Antonio Bianco, MD, PhD

Dean, John Sealy School of MedicineSenior Vice President, Health Affairs Chief Research OfficerProfessor, Department of Internal Medicine – EndocrinologyThe Robert A. Welch Distinguished University Chair in Chemistry University of Texas ...

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What is your approach to persons who have a TSH level between 4.5 and 10? Do they all get treated, or are there other stratification criteria—i.e., the presence of antithyroid antibodies—you use to determine the need for thyroid hormone therapy?

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Once you begin thyroid hormone replacement therapy, how is that patient followed clinically to ensure treatment success? What are the recommended starting doses? How do you titrate the dose over time?

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Can you give clinicians a sense of how many people treated for hypothyroidism with T4 monotherapy fall into a “less than optimal outcome” category and should be considered for combination approaches, including those that might include DTE?

Can you give clinicians a sense of how many people treated for hypothyroidism with T4 monotherapy fall into a “less than optimal outcome” category and should be considered for combination approaches, including those that might include DTE?

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There is a subset of patients who don’t respond to or are dissatisfied with levothyroxine (T4) monotherapy. What percentage don’t respond to conventional therapy? Why is combination therapy with T3/T4 considered appropriate for this group?

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