- Last edited on April 30, 2020
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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. | ||