Endocrine Abstracts

Inappropriately raised TSH levels in patients on thyroxine replacement therapy are frequently encountered in clinical practice. Following discussing patient compliance with medication, causes of thyroxine malabsorption including drug interactions, coeliac disease or autoimmune gastritis should be considered. We describe the investigation of a patient with persistently elevated TSH levels in spite of apparently taking adequate thyroxine replacement.Case H...

Introduction: Vitamin D deficiency/insufficiency in patients with primary hyperparathyroidism may be associated with more severe and progressive disease. In such patients there is higher levels of parathormone and markers of bone turnover, large parathyroid adenomas and more frequent fractures than vitamin D replete patients.Aims and objectives: To determine whether vitamin D repletion of patients with PHPT and co-existing vitamin D insufficiency or defi...

Forty two year Mrs SJ, community support worker with a background history of hypothyroidism was referred by her GP with excessive tiredness and weight gain. She had been attending her surgery for few months with somatic symptoms and her GP had noticed significant change in facial characteristics and large hands. She complained of increase in her feet size from a size 6 to a 9. No disturbance of vision was reported.She was noted to have hyperglycaemia and...

Context: Up to 15% of people with hypothyroidism remain symptomatic despite treatment with levothyroxine. A proportion of these utilise combination thyroid hormone replacement, T3 monotherapy and desiccated thyroid extract (DTE). We sought to explore thyroid hormone profiles in these patients.Methods: We performed hourly blood tests (8.30am-4.30pm) to assess TSH, T3 and T4 levels in 49 individuals (n =14 combination thyroid hormone replacement, ...

Context: Approximately 10% of patients on levothyroxine remain symptomatic despite restoration of biochemical euthyroidism. Some therefore utilise alternatives to levothyroxine monotherapy including combination thyroid hormone replacement, T3 monotherapy and desiccated thyroid extract (DTE). We examined thyroid hormone profiles in these patients.Methods: We examined 49 individuals 14 on combination thyroid hormone replac...