Endocrine Abstracts

This review will address the following questions i) what is the evidence that levothyroxine replacement alone is insufficient to deal with the treatment of hypothyroidism; ii) what is the evidence form randomised control studies that combinations of tri-iodothyronine and levothyroxine are superior to levothyroxine alone in replacement treatment for hypothyroidism; iii) what other factors may be involved in the optimal replacement of thyroid hormone deficiency and iv) what conc...

The thyroid gland undergoes several anatomical changes with age and both overt and subclinical thyroid dysfunction a more prevalent in elderly patients. Recent reports have convincingly shown a physiological rise in serum TSH concentrations in the elderly and studies on autoimmunity have indicated an age-related prevalence of antithyroid antibodies. Interpreting thyroid function tests in elderly patients may be complicated by an increased prevalence of co-existing chronic dise...

Persistence of elevated TSH levels despite large doses of L-thyroxin is not uncommon, although thyroxin substitution is usually easy and convenient. The first cause to be considered is thyroxin malabsorption, whether organic, due to concomitant gastric or intestinal disease, or bariatric surgery, or, more frequently, related to dietary or drug interference. Proton-pump inhibitors, antacids and a long list of drugs may decrease thyroxin absorption. Drugs and thyr...