Grades of Hypothyroidism

Evered, David; Ormston, B. J.; Smith, Pamela Alethea; Hall, R.; Bird, T.

doi:10.1136/bmj.1.5854.657

Cited by 317 publications

(122 citation statements)

References 15 publications

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“…In human patients, the term subclinical hypothyroidism is used to describe the finding of a high serum TSH concentration together with a normal (usually low‐normal) T 4 concentration 32, 33. By definition, subclinical hypothyroidism is a biochemical diagnosis because few, if any, clinical features of thyroid failure are present 34, 35, 36, 37.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Low‐dose (2 millicurie) versus Standard‐dose (4 millicurie) Radioiodine Treatment for Cats with Mild‐to‐Moderate Hyperthyroidism

Lucy

Peterson

Randolph

et al. 2017

Veterinary Internal Medicne

127

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BackgroundRadioiodine (131I) is effective treatment for hyperthyroidism in cats, but optimal dose to restore euthyroidism without inducing hypothyroidism is unclear. Treatment‐induced hypothyroidism can lead to azotemia and reduced duration of survival.ObjectiveTo compare efficacy and short‐term outcomes of low‐dose 131I versus higher, standard‐dose 131I as treatment for hyperthyroidism.AnimalsA total of 189 client‐owned cats undergoing 131I treatment for mild‐to‐moderate hyperthyroidism (serum T4 ≥ 4.0 μg/dL and <13.0 μg/dL).MethodsProspective, nonrandomized, cohort study comparing treatment with either low‐dose (2 mCi, n = 150) or standard‐dose (4 mCi, n = 39) 131I. Serum T4, thyroid‐stimulating hormone (TSH), and creatinine concentrations were measured after 1, 3, and 6 months to determine persistent hyperthyroidism, overt hypothyroidism (low T4, high TSH), subclinical hypothyroidism (normal T4, high TSH), and azotemia.ResultsThere was no significant difference in prevalence of cats with persistent hyperthyroidism between standard‐ and low‐dose treatment groups at 3 (0% versus 5.3%; P = .34) and 6 (0% versus 3.3%; P = .51) months. Overt (18% versus 1%; P = .0005) or subclinical (46% versus 21%; P = .004) hypothyroidism was more common in cats at 6 months after standard‐dose 131I. No difference in incidence of azotemia existed between groups, but cats treated with standard‐dose 131I had higher creatinine concentrations (P < .05) and higher percent rises in creatinine (P < .0001).Conclusions and Clinical ImportanceLow‐dose 131I is safe and effective for cats with mild‐to‐moderate hyperthyroidism, as evidenced by a cure rate of >95% with reduced frequency of iatrogenic hypothyroidism and azotemia.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Low‐dose (2 millicurie) versus Standard‐dose (4 millicurie) Radioiodine Treatment for Cats with Mild‐to‐Moderate Hyperthyroidism

Lucy

Peterson

Randolph

et al. 2017

Veterinary Internal Medicne

127

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“…7 Although subclinical disease is frequently "asymptomatic," many patients have symptoms of thyroid hormone deficiency. 65,66 Lipid metabolism is altered in subclinical hypothyroidism. 64,67 Patients have increased serum lipid levels, and cholesterol levels appear to rise in parallel with serum TSH.…”

Section: Subclinical Thyroid Diseasementioning

confidence: 99%

Thyroid Disease and the Heart

Klein¹,

Danzi²

2016

Current Problems in Cardiology

146

104

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Abstract-The cardiovascular signs and symptoms of thyroid disease are some of the most profound and clinically relevant findings that accompany both hyperthyroidism and hypothyroidism. On the basis of the understanding of the cellular mechanisms of thyroid hormone action on the heart and cardiovascular system, it is possible to explain the changes in cardiac output, cardiac contractility, blood pressure, vascular resistance, and rhythm disturbances that result from thyroid dysfunction. The importance of the recognition of the effects of thyroid disease on the heart also derives from the observation that restoration of normal thyroid function most often reverses the abnormal cardiovascular hemodynamics. In the present review, we discuss the appropriate thyroid function tests to establish a suspected diagnosis as well as the treatment modalities necessary to restore patients to a euthyroid state. We also review the alterations in thyroid hormone metabolism that accompany chronic congestive heart failure and the approach to the management of patients with amiodarone-induced alterations in thyroid function tests.

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“…[1][2][3][4] Yet hypothyroidism often remains undetected because of the difficulty with ascribing symptoms to disease. The pathophysiologic changes generally require months or years to manifest as clinical signs and symptoms.…”

mentioning

confidence: 99%

Do traditional symptoms of hypothyroidism correlate with biochemical disease?

1997

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OBJECTIVE:Hypothyroidism often remains undetected because of the difficulty associating symptoms with disease. To determine the relation between symptoms and biochemical disease, we assessed symptoms and serum thyroid function tests, concurrently, for patients with and without hypothyroidism. DESIGN:Cross-sectional study. SETTING/PATIENTS: CONCLUSIONS:In this sample, the number of hypothyroid symptoms reported was directly related to the level of TSH. The association was stronger when more symptoms were reported. Symptoms that had changed in the past year were more powerful than symptoms reported present at the time of testing. This suggests that traditional symptoms are valuable when deciding which patients to test for hypothyroidism.

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Grades of Hypothyroidism

Cited by 317 publications

References 15 publications

Efficacy of Low‐dose (2 millicurie) versus Standard‐dose (4 millicurie) Radioiodine Treatment for Cats with Mild‐to‐Moderate Hyperthyroidism

Efficacy of Low‐dose (2 millicurie) versus Standard‐dose (4 millicurie) Radioiodine Treatment for Cats with Mild‐to‐Moderate Hyperthyroidism

Thyroid Disease and the Heart

Do traditional symptoms of hypothyroidism correlate with biochemical disease?

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