Increased levothyroxine requirement in a woman with previously well-controlled hypothyroidism and intestinal giardiasis

Radaeli, Rafael de Figueiredo; Diehl, Leandro Arthur

doi:10.1590/s0004-27302011000100012

Cited by 11 publications

(10 citation statements)

References 16 publications

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“…Clinical manifestations range from severe gastrointestinal derangement to asymptomatic forms (162). Only two case reports described an increased need for thyroxine due to the GL infestation (163,164), both describing an elevation of serum TSH and an increased need for thyroxine that were reversed by appropriate antiparasitic treatment. The cause of thyroxine malabsorption in these patients is the inflammatory mucosal damage and epithelial apoptosis induced by the protozoan (165); furthermore, in these patients an increased intestinal permeability may be observed, due to the disruption of the intestinal tight junctions (166).…”

Section: Advance Article: Endocrine Reviewsmentioning

confidence: 99%

Gastrointestinal Malabsorption of Thyroxine

et al. 2018

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Section: Advance Article: Endocrine Reviewsmentioning

confidence: 99%

Gastrointestinal Malabsorption of Thyroxine

et al. 2018

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“…Chronic gastritis, Helicobacter pylori and Giardia infections can also decrease L-T4 absorption, and should be considered (204,205) …”

Section: How To Approach Hypothyroid Patients With Persistently High mentioning

confidence: 99%

Clinical practice guidelines for the management of hypothyroidism

Brenta

Vaisman

Sgarbi

et al. 2013

Arq Bras Endocrinol Metab

114

108

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Introduction: Hypothyroidism has long been known for its effects on different organ systems, leading to hypometabolism. However, subclinical hypothyroidism, its most prevalent form, has been recently related to cardiovascular risk and also to maternal-fetal complications in pregnant women. Objectives: In these clinical practice guidelines, several aspects of this field have been discussed with the clear objectives of helping physicians treat patients with hypothyroidism, and of sharing some of our Latin American-based clinical experience. Materials and methods: The Latin American Thyroid Society commissioned a Task Force on Hypothyroidism to develop evidence-based clinical guidelines on hypothyroidism. A systematic review of the available literature, focused on the primary databases of MedLine/PubMed and Lilacs/SciELO was performed. Filters to assess methodological quality were applied to select the best quality studies. The strength of recommendation on a scale from A-D was based on the Oxford Centre for Evidence--based Medicine, Levels of Evidence 2009, allowing an unbiased opinion devoid of subjective viewpoints. The areas of interest for the studies comprised diagnosis, screening, treatment and a special section for hypothyroidism in pregnancy. Results: Several questions based on diagnosis, screening, treatment of hypothyroidism in adult population and specifically in pregnant women were posed. Twenty six recommendations were created based on the answers to these questions. Despite the fact that evidence in some areas of hypothyroidism, such as therapy, is lacking, out of 279 references, 73% were Grade A and B, 8% Grade C and 19% Grade D. Conclusions: These evidence-based clinical guidelines on hypothyroidism will provide unified criteria for management of hypothyroidism throughout Latin America. Although most of the studies referred to are from all over the world, the point of view of thyroidologists from Latin America is also given. Arq Bras Endocrinol Metab. 2013;57(4):265-99

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“…in poor sanitary conditions [63]. If repeated three times, fecal positivity of ova and parasites occurs in greater than 85% of cases [63].…”

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confidence: 99%