Wednesday, December 30, 2009

Subclinical Hypothyroidism, Clinical Practice NEJM 2001

A 59-year-old woman is found to have a serum thyrotropin level of 7 mU per liter on routine screening. Her only symptoms are mild fatigue, which has been present for more than 10 years, and difficulty losing weight. The results of the physical examination are normal, except for the finding of a small, firm thyroid with a slightly irregular
surface. The serum cholesterol level is 220 mg per deciliter (5.69 mmol per liter), the low-density lipoprotein (LDL) cholesterol level is 140 mg per deciliter (3.62 mmol per liter), and a test for antibodies against thyroperoxidase is positive. Should treatment with thyroxine be initiated?... Authorized only

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