Clinical Thyroidology
for Patients

August 2008 Volume 1 Issue 1

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Clinical Thyroidology for Patients August 2008 Volume 1 Issue 1 (PDF file, 611 KB)

TABLE OF CONTENTS - Web Format

1. THYROID DIAGNOSIS Lowering the TSH reference limit to 2.5 μIU/ml may result in inappropriate therapy
2. AUTOIMMUNE THYROID DISEASE Autoimmune thyroid failure is higher than usual among thyroid anti-body positive individuals on an excessive iodine diet
3. NODULAR GOITER Aggressive thyroid cancers may be missed in patients with multinodular goiter without ultrasound surveillance
4. THYROID NODULES The likelihood of a radiation induced thyroid nodule being malignant depends neither on its size nor number and biopsying only the largest nodule can miss up to half the thyroid cancers
5. THYROID NODULES Preoperative neck ultrasound examination accurately identifies most malignant nodules in patients with fine‐needle aspiration cytology results that are suspicious for malignancy
6. THYROID CANCER PET/MRI fusion studies in patients with differentiated thyroid cancer
7. COMPLICATIONS OF RADIOIODINE THERAPY There is a small risk of second primary nonthyroidal malignancies in patients with differentiated thyroid cancer treated with radioiodine
8. THYROID CANCER Tumor recurrence after preparing patients with thyroid hormone withdrawal or recombinant human TSH-a for 131I therapy is similar
9. THYROID CANCER Patients with papillary microcarcinoma older than 55 years have high tumor recurrence rates but low cancer-specific mortality rates after follow-up for 35 years
10. THYROID HORMONE THERAPY Daily levothyroxine requirements increased by almost 20% when parietal cell antibodies are present and 26% when gastric atrophy is present, and worsens with gastric atrophy GRAVES’ DISEASE Radioiodine therapy for Graves’ hyperthyroidism may have an effect on the eye component of Graves’ disease
11. GRAVES’ DISEASE Radioiodine therapy for Graves’ hyperthyroidism may have an effect on the eye component of Graves’ disease
12. NONTHYROIDAL EFFECTS OF RADIOIODINE There is little effect of radioiodine on the ovaries and offspring over a 10 year period
13. GRAVES’ DISEASE After antithyroid drug withdrawal, nearly half the relapses of Graves’ hyperthyroidism are transient and require no further therapy
14. THYROTOXICOSIS Patients with hyperthyroidism treated with radioiodine may be at increased risk of long-term morbidity and hospitalization for arrhythmias and cardiovascular disease, which it is more likely an effect of hyperthyroidism than radioiodine
15. THYROTOXICOSIS Patients with subclinical thyrotoxicosis experience significant improvements in mood and Patients with subclinical thyrotoxicosis experience significant improvements in mood and motor learning but have minor declines in self-perceived general and physical health status
16. HYPERTHYROIDISM Patients younger than 65 years of age who have subclinical hyperthyroidism have a somewhat different outcome than older patients, depending on the cause of the thyrotoxicosis
17. THYROID CANCER One in five patients with widely metastatic follicular thyroid cancer has T3 thyrotoxicosis from increased tumor deiodinase activity that can be identified by measuring serum T3 levels and stopping levothyroxine therapy
18. HYPOTHYROIDISM Adding liothyronine (T3) to levothyroxine replacement therapy is not necessary to achieve normal serum T3 levels and euthyroidism
19. HYPOTHYROIDISM The diagnosis of subclinical hypothyroidism is severely limited by a single set of thyroid function tests and the biologic variation in thyroid testing from visit to visit and levothyroxine treatment be withheld until the diagnosis is verified
20. THYROID HORMONE THERAPY Taking famotidine and esomeprazole for a short period of time does not impair thyroid hormone absorption
21. THYROID HORMONE THERAPY Coffee interferes with the intestinal absorption of levothyroxine
22. THYROID AND ERECTILE DYSFUNCTION Men with hyperthyroidism or hypothyroidism commonly have erectile dysfunction