Please register or login to view the chart

Primary hypothyroidism -management and follow up

Primary hypothyroidism –management recommendations by NICE , Offer levothyroxine ( LT4 ) as first line treatment.

 

do not routinely offer liothyronine ( LT3 ) either alone or in combination
○ T3 is the active thyroid hormone , majority is produced by the peripheral conversion of levothyroxine ( T4 )
○ it is more difficult to select , monitor and adjust the dose of T3 preparations
○ potential risks from T3 as osteoporosis and arrhythmia
○ T3 ( Liothyronine 20 mcg tablets are quite expensive , about £ 244 for 28 tablets ) NICE does not support use of T3 as there is not enough evidence that it offers benefit over levothyroxine (T4 ) and its long term effects are uncertain (for the same reason NICE does not recommend use of natural thyroid extract )

 

aim to maintain TSH within reference range adjust dose further if symptoms persist to achieve optimal well-being but avoid using doses that cause TSH suppression or thyrotoxicosis in people with a very high TSH before starting treatment or a prolonged period of untreated hypothyroidism it may take up to 6 months for the TSH to return to the reference range

REFERENCES

  1. Thyroid disease : assessment and management NICE Guideline 145 November 2019 Recommendations | Thyroid disease: assessment and management | Guidance | NICE
  2. North of Tyne Area and Gateshead Area Prescribing Committee Liothyronine (T3) for Hypothyroidism – Prescribing Guideline http://www.northoftyneapc.nhs.uk/wp-content/uploads/sites/6/2018/10/Liothyronine-prescribing-guidance-v0.4.pdf

 

 

Share

Related Charts:

Add Your Comments

Your email address will not be published.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

A4 Medicine  - Search Less and Learn More

Welcome to the A4 medicine community where we are constantly working to provide exceptional educational material to primary health care professionals. Subscribe to our website for complete access to our A4 Charts. They are aesthetically designed charts that contain 300 (plus and adding) common and complex medical conditions with the all information required for primary care in one single page that can help you in consultation/practice and exam.

Additionally, you will get complete access for our Learn From Experts : A4 Webinar Series in which domain experts share the video explainer presentation on one medical condition in one hour for the primary care. And you will also get a hefty discount on our publications and upcoming digital products.

We are giving a lifetime flat 30% discount to our first thousand users, discount code already applied to checkout.