Primary Hypothyroidism in Adults

Research Review Educational Series Online Module

Begin

Primary Hypothyroidism in Adults

This Research Review Educational Series Online Module provides detailed insight into disease-background and disease-management issues in primary hypothyroidism for New Zealand GPs.

To complete the module you will need to read the Educational Series 'Primary Hypothyroidism in Adults' and then answer a series of questions relating to the content. We expect it will take you approximately 1 hour in total to complete the reading and the questions.

Click here to view the document

You can view the document online, download it or print.

This Educational Series Online Module covers:

  • Disease-background and disease-management issues in primary hypothyroidism
  • Biochemical classification of hypothyroidism
  • Causes of hypothyroidism
  • Diagnosis and testing
  • Problems with delayed diagnosis
  • Treatment options for overt hypothyroidism
  • Under- or over-treatment
  • Ongoing monitoring
  • Management of poor responses to treatment
  • Management of primary hypothyroidism in special populations
  • Patients with persistent symptoms
  • Hypothyroidism during pregnancy
  • Myxoedema coma

Learning Outcomes

After completing this module you will improve your knowledge of:

  • Which patients to screen for hypothyroidism, based on current best practice in New Zealand
  • The importance of managing hypothyroidism
  • Treatment options available in New Zealand, and how to monitor & manage treatment
  • Management of special cases

Contributing Experts

Expert commentary is provided by Endocrinologist Dr Rick Cutfield of Waitemata District Health Board, Auckland.

Module questions have been developed by Dr Chris Tofield, who works part time in General Practice in Tauranga, is involved with clinical research and is clinical advisor to Bay of Plenty District Health Board.

Accreditation

The “Primary Hypothyroidism in Adults Online Module” has been endorsed by The Royal New Zealand College of General Practitioners (RNZCGP) and has been approved for 1 hours CME for General Practice Educational Programme 2/3 (GPEP) and Continuing Professional Development (CPD) purposes.
Further info

References

  • So M, MacIsaac RJ, Grossmann M. Hypothyroidism. Aust Fam Physician 2012;41:556–62.
  • Okosieme O, Gilbert J, Abraham P, et al. Management of primary hypothyroidism: statement by the British Thyroid Association Executive Committee. Clin Endocrinol (Oxf) 2016;84:799–808.
  • Nygaard B. Hypothyroidism (primary). BMJ Clin Evid 2014;2014.
  • BPAC. Management of thyroid dysfunction in adults. Available from: http://www.bpac.org.nz/BPJ/2010/December/docs/bpj_33_thyroid_pages_22-32.pdf [accessed 23 August 2016].
  • Gibbons V, Conaglen JV, Lillis S, et al. Epidemiology of thyroid disease in Hamilton (New Zealand) general practice. Aust N Z J Public Health 2008;32:421–3.
  • Gaitonde DY, Rowley KD, Sweeney LB. Hypothyroidism: an update. Am Fam Physician 2012;86:244–51.
  • Chakera AJ, Pearce SH, Vaidya B. Treatment for primary hypothyroidism: current approaches and future possibilities. Drug Des Devel Ther 2012;6:1–11.
  • O’Leary PC, Feddema PH, Michelangeli VP, et al. Investigations of thyroid hormones and antibodies based on a community health survey: the Busselton thyroid study. Clin Endocrinol (Oxf) 2006;64:97–104.
  • Empson M, Flood V, Ma G, et al. Prevalence of thyroid disease in an older Australian population. Intern Med J 2007;37:448–55.
  • Topliss DJ, Eastman CJ. 5: Diagnosis and management of hyperthyroidism and hypothyroidism. Med J Aust 2004;180:186–93.
  • Jansen SW, Akintola AA, Roelfsema F, et al. Human longevity is characterised by high thyroid stimulating hormone secretion without altered energy metabolism. Sci Rep 2015;5:11525.
  • Liwanpo L, Hershman JM. Conditions and drugs interfering with thyroxine absorption. Best Pract Res Clin Endocrinol Metab 2009;23:781–92.
  • Morris JC. How do you approach the problem of TSH elevation in a patient on high-dose thyroid hormone replacement? Clin Endocrinol (Oxf) 2009;70:671–3.
  • Devdhar M, Ousman YH, Burman KD. Hypothyroidism. Endocrinol Metab Clin North Am 2007;36:595–615.
  • Benvenga S, Bartolone L, Pappalardo MA, et al. Altered intestinal absorption of L-thyroxine caused by coffee. Thyroid 2008;18:293–301.
  • Villar HC, Saconato H, Valente O, Atallah AN. Thyroid hormone replacement for subclinical hypothyroidism. Cochrane Database Syst Rev 2007;(3):CD003419.
  • Garber JR, Cobin RH, Gharib H, et al. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocr Pract 2012;18:988–1028.
  • Walsh JP, Ward LC, Burke V, et al. Small changes in thyroxine dosage do not produce measurable changes in hypothyroid symptoms, well-being, or quality of life: results of a double-blind, randomized clinical trial. J Clin Endocrinol Metab 2006;91:2624–30.
  • Grozinsky-Glasberg S, Fraser A, Nahshoni E, et al. Thyroxine-triiodothyronine combination therapy versus thyroxine monotherapy for clinical hypothyroidism: meta-analysis of randomized controlled trials. J Clin Endocrinol Metab 2006;91:2592–9.
  • Stagnaro-Green A, Abalovich M, Alexander E, et al. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid 2011;21:1081–125.