Diagnosis and treatment of hypothyroidism in a family medicine practice

Abstract:

Initial screening for suspected hypothyroidism based on symptoms or risk factors is performed by measuring the value of thyroid-stimulating hormone (TSH) in the blood. If its value is elevated, the measurment is to be repeated in 6 to 8 weeks with the measurement of free thyroxine (fT4). To confirm the diagnosis of autoimmune thyroiditis, it is possible to measure the value of anti-TPO (antibodies to thyroid peroxidase). Once confirmed positive, antibodies do not need to be measured repeatedly. According to Australian guidelines, thyroid ultrasound is indicated in case there is an obvious palpable solitary or dominant nodule in the area of the thyroid or goitre. It is not necessary to do it for the purpose of establishing the diagnosis and routine monitoring of primary hypothyroidism or when finding elevated anti-TPO. Routine screening for thyroid nodules or thyroid cancer is also not recommended.

Key words:
diagnostics; hypothyroidism; family medicine; thyroid; treatment