Subclinical hyperthyroidism: possible danger of overzealous thyroxine replacement therapy.

Abstract:

:Many patients taking customary doses of levothyroxine have slightly elevated serum thyroxine (T4), apparently normal serum triiodothyronine, suppressed serum thyrotropin (thyroid-stimulating hormone; TSH) concentrations, and no clinical symptoms of hyperthyroidism. Recent reports suggest that these patients may have adverse effects from subclinical hyperthyroidism, including abnormally short systolic time intervals, elevations in liver enzymes, and reductions in bone density. Controversy exists about which thyroid function tests should be used to monitor patients taking levothyroxine. A review of currently available data suggests that replacement doses of levothyroxine given to hypothyroid patients should be adjusted so that serum TSH measured by the new sensitive assays is within the normal range. Patients requiring suppressive doses of levothyroxine to shrink goitrous thyroid tissue or to prevent growth of abnormal tissue should be given the minimal dose needed to accomplish the desired clinical or biochemical response.

journal_name

Mayo Clin Proc

journal_title

Mayo Clinic proceedings

authors

Ross DS

doi

10.1016/s0025-6196(12)65409-3

subject

Has Abstract

pub_date

1988-12-01 00:00:00

pages

1223-9

issue

12

eissn

0025-6196

issn

1942-5546

pii

S0025-6196(12)65409-3

journal_volume

63

pub_type

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