The American Association of Clinical Endocrinologists and the American Thyroid Association released guidelines for the evaluation and treatment of hypothyroidism after a study was conducted by Jeffrey R. Garber, MD , along with other researchers. These guidelines were published simultaneously in the Thyroid and Endocrine Practice. Read the full study here.
The measurement of TSH is a commonly used test to check thyroid function. TSH levels are directly related to thyroid hormone levels. When thyroid hormone levels fall below a set-point, it triggers an increase in TSH. Levels of TSH gradually increase during the aging process.
Recommendations for Hypothyroidism
In total 52 recommendations were made based on the evidence collected. The goal is to establish an optimal assessment process for patients potentially dealing with hypothyroidism, followed by an effective treatment protocol. Some of the main factors established included:
- Mild TSH elevations in the elderly may be a normal symptom of aging and does not always represent the need for treatment of hypothyroidism.
- The TSH test is the single best hypothyroidism test that’s available. However, it is insufficient for assessing hospitalized patients or when central hypothyroidism was suspected or already existing.
- The standard treatment for hypothyroidism is an individually tailored replacement using levothyroxine. To date there is no evidence that over-the-counter products advertised as “thyroid support” are effective in any way.
- Levothyroxine and levotriiodothyronine combinations should never be used in women who are pregnant or where the potential to conceive is present
- Clinicians are advised to consult with an endocrinologist when treating hypothyroidism in pediatric patients, patients with heart disease, women who may become pregnant, and those with other endocrine, as well as patients for whom it is difficult to maintain a normal thyroid levels. For example, those with goiter may have difficulty maintaining normal thyroid levels.
The guidelines addressed numerous issues that clinicians come across in the diagnosis and treatment of a thyroid disorder. The
Dr Charles Emerson
Charles H. Emerson, MD, said in a news release Dr. Emerson is editor-in-chief of Thyroid and professor emeritus of medicine at the University of Massachusetts Medical School in Worcester. “They deal firmly with the problem of inappropriate thyroid hormone administration, both as it concerns individuals who should not be taking thyroid hormone, and patients with hypothyroidism who are given or self-administer suboptimal doses or dangerous formulations for their condition.
 Jeffrey R. Garber, M.D. is Chair of the American Association of Clinical Endocrinologists and American Thyroid Association Taskforce on Hypothyroidism in Adults.