OBJECTIVES The recommended starting dose of levothyroxine (LT4) in primary hypothyroidism is 1.6 μg/kg body weight and is based on presumption of minimal residual thyroid function in autoimmune hypothyroidism. This study aimed at finding the range and determining factors for LT4 dose in long-standing hypothyroidism. METHODS A cross-sectional study of individuals with primary autoimmune hypoth...

A 12-year-old girl presented with acute abdominal pain due to an acute ovarian torsion. She required an oophorectomy. Clinical and laboratory assessment confirmed severe primary hypothyroidism. In this report, we review this rare complication of untreated primary hypothyroidism and the physiologic mechanisms proposed to explain this phenomenon.

Abstract Background Hypothyroidism usually appears in the second decade of life and is thought to be associated with iron overload in patients with thalassemia major. This study aimed to evaluate thyroid dysfunctions in patients with beta-thalassemia major. Materials and Methods This research is a descriptive – cross sectional study, carried out in 2009 to assess thyroid function in 100 p...

The development of spontaneous hyperthyroidism following primary hypothyroidism is an unusual occurrence. We report two cases of confirmed primary hypothyroidism who subsequently became hyperthyroid. Thyroid stimulating antibodies were present in the sera of both patients during the hyperthyroid state. The significance of this sequence of events is discussed and a possible explanation proposed.

In the treatment of primary hypothyroidism, guidelines issued by some organizations advise merely normalizing the TSH, reducing it to any value within the reference range. However, many studies show that this approach often produces little improvement in symptoms or in the risk of diseases associated with hypothyroidism. For this reason, some organizations and experts recommend titrating T4 dos...

We measured total thyroxin (Tr4), free thyroxin(FT4, total triiodothyronine (TT3), free triiodothyronine (FT3), and thyrotropin (TSH) in serum sampled before and 1, 2, 4, 6, and 8 h after administration of prescribed doses of thyroxin to 12 patients with proven primary hypothyroidism. At 2, 4, and 6 h post-dose, the mean values for 114 and FT4 and also that at 8 h for FT4 significantly (P <0.05...

Two cases of primary hypothyroidism with hypopituitarism in elderly patients are reported. The elevated levels of thyroid stimulating hormone led to delay in the recognition of accompanying pituitary failure. Elderly patients should not be commenced on thyroxine replacement therapy until the possibility of hypopituitarism and cortisol deficiency has been excluded.

Studies in hypothyroid rats show that, when infused with a combination of thyroxine (T4) plus triiodothyronine (T3) to normalize thyrotropin (TSH), euthyroidism in all organs is only ensured when T(4) and T(3) are administered in a ratio as normally secreted by the rat thyroid. As substitution with T(4)-only results in an abnormal serum T(4)/T(3) ratio, it is also possible that in humans, euthy...

A strategy for testing thyroid function with discretionary assay of thyroid stimulating hormone (TSH) following initial measurement of total plasma thyroxine (tT4) was retrospectively evaluated in relation to the diagnosis of primary hypothyroidism. Over a two year period 14 641 tT4 assays were done and 6887 TSH assays, of which 29% were initiated in the laboratory. The percentage of raised TSH...

A 44 year old lady with primary hypothyroidism presented with massive pericardial effusion without cardiac tamponade. Pericardial tap was done twice and the effusion resolved as the hypothyroid state improved. She remained hypertensive despite the euthyroid state. She was discharged well with L-thyroxine and anti-hypertensive therapy.