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cl:thyroid-disorders [on February 14, 2020]
cl:thyroid-disorders [on December 14, 2021] (current)
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 ====== Thyroid Disorders and Diseases ====== ====== Thyroid Disorders and Diseases ======
 +{{INLINETOC}}
 +===== Primer =====
 <WRAP group> <WRAP group>
 <WRAP half column> <WRAP half column>
-===== Primer ===== 
 **Thyroid Disorders and Diseases** are a group of medical conditions that affect the function of the thyroid gland. **Thyroid Disorders and Diseases** are a group of medical conditions that affect the function of the thyroid gland.
- 
-==== Postpartum ==== 
-Thyroid peroxidase antibody (TPO) is elevated in 20% of women with postpartum psychosis, compared to 5-7% of all postpartum women.[([[https://​www.ncbi.nlm.nih.gov/​pubmed/​21343331|Bergink,​ V., Kushner, S. A., Pop, V., Kuijpens, H., Lambregtse-van den Berg, M. P., Drexhage, R. C., ... & Drexhage, H. A. (2011). Prevalence of autoimmune thyroid dysfunction in postpartum psychosis. The British Journal of Psychiatry, 198(4), 264-268.]])] There is an association between postpartum thyroid dysfunction and depression. In some cases, TSH should be ordered in women with a history of goitre, type I diabetes, prior postpartum depression, thyroid disease history (including prior low free T4 level), a family history of thyroid disease, or a personal history of smoking. If the TSH level is abnormal, a free T4 should also be ordered.[([[https://​www.ncbi.nlm.nih.gov/​pubmed/​11588143|Muller,​ A. F., Drexhage, H. A., & Berghout, A. (2001). Postpartum thyroiditis and autoimmune thyroiditis in women of childbearing age: recent insights and consequences for antenatal and postnatal care. Endocrine reviews, 22(5), 605-630.]])] 
- 
 </​WRAP>​ </​WRAP>​
 <WRAP half column> <WRAP half column>
-== Thyroid Disorders and Diseases == +<​catlist ​cl:​thyroid-disorders: -columns:1 -noAddPageButton -sortAscending -noNSInBold>​
-~~DIR:::cl:​thyroid-disorders?&​noheader~~+
 </​WRAP>​ </​WRAP>​
 </​WRAP>​ </​WRAP>​
  
-==== Thyroid Nodules ​==== +===== Screening ===== 
-  * [[https://​www.mdedge.com/​clinicianreviews/​article/​143519/​endocrinology/​thyroid-nodule-malignant|]] +  * Asymptomatic,​ non-pregnant,​ adults over the age of 18, with no prior history of thyroid disorders are recommended to not have routine screening for thyroid dysfunction.[([[https://​pubmed.ncbi.nlm.nih.gov/​31740537/​|Birtwhistle,​ R., Morissette, K., Dickinson, J. A., Reynolds, D. L., Avey, M. T., Domingo, F. R., ... & Thombs, B. D. (2019). Recommendation on screening adults for asymptomatic thyroid dysfunction in primary care. CMAJ, 191(46), E1274-E1280.]])] Generally speaking, if a patient has depressive symptoms or cognitive dysfunction,​ then they are not asymptomatic. 
-  * [[https://​www.mdedge.com/​clinicianreviews/​article/​71989/​endocrinology/​thyroid-nodules|]]+  * Females with hypothyroidism are the most susceptible to depression, while the association of depression with other thyroid conditions is less than previously thought.[([[https://​pubmed.ncbi.nlm.nih.gov/​34524390/​|Bode,​ H., Ivens, B., Bschor, T., Schwarzer, G., Henssler, J., & Baethge, C. (2021). Association of Hypothyroidism and Clinical Depression A Systematic Review and Meta-analysis. JAMA, 78(12), 1375-1383.]])] 
 +===== Depression ===== 
 +Treatment of subclinical hypothyroidism in adults with depression has been shown to improve depressive symptoms.[([[https://​pubmed.ncbi.nlm.nih.gov/​25775223/​|Najafi,​ L., Malek, M., Hadian, A., Ebrahim Valojerdi, A., Khamseh, M. E., & Aghili, R. (2015). Depressive symptoms in patients with subclinical hypothyroidism–the effect of treatment with levothyroxine:​ a double-blind randomized clinical trial. Endocrine research, 40(3), 121-126.]])] 
 + 
 + 
 +===== Physical Exam ===== 
 +  * [[https://​www.mdedge.com/​clinicianreviews/​article/​143519/​endocrinology/​thyroid-nodule-malignant|Clinician Reviews: Is that thyroid nodule malignant?]] 
 +  * [[https://​www.mdedge.com/​clinicianreviews/​article/​71989/​endocrinology/​thyroid-nodules|Clinician Reviews: Thyroid Nodules]] 
 + 
 + 
 +===== Special Populations ===== 
 + 
 +==== Postpartum ==== 
 +Thyroid peroxidase antibody (TPO) is elevated in 20% of women with postpartum psychosis, compared to 5-7% of all postpartum women.[([[https://​www.ncbi.nlm.nih.gov/​pubmed/​21343331|Bergink,​ V., Kushner, S. A., Pop, V., Kuijpens, H., Lambregtse-van den Berg, M. P., Drexhage, R. C., ... & Drexhage, H. A. (2011). Prevalence of autoimmune thyroid dysfunction in postpartum psychosis. The British Journal of Psychiatry, 198(4), 264-268.]])] There is an association between postpartum thyroid dysfunction and depression. In some cases, TSH should be ordered in women with a history of goitre, type I diabetes, prior postpartum depression, thyroid disease history (including prior low free T4 level), a family history of thyroid disease, or a personal history of smoking. If the TSH level is abnormal, a free T4 should also be ordered.[([[https://​www.ncbi.nlm.nih.gov/​pubmed/​11588143|Muller,​ A. F., Drexhage, H. A., & Berghout, A. (2001). Postpartum thyroiditis and autoimmune thyroiditis in women of childbearing age: recent insights and consequences for antenatal and postnatal care. Endocrine reviews, 22(5), 605-630.]])] 
 +==== Older adults ==== 
 +<alert icon="​fa fa-arrow-circle-right fa-lg fa-fw" type="​success">​See main article: **[[geri:​dementia:​home|]]**</​alert>​ 
 +Screening for thyroid dysfunction is a part of the work up for cognitive impairment and dementias.