HYPOTHYROIDISM IN FAMILY MEDICINE DIAGNOSIS AND MANAGEMENT

Hypothyroidism is defined as failing of the thyroid gland to produce sufficient thyroid hormone to fulfill the metabolic demands of the body. In this review we discuss the proper diagnostic and management methods in primary care. Without treatment, hypothyroidism can lead to high blood pressure, dyslipidemia, infertility, cognitive impairment, and neuromuscular disorder. We conducted a narrative review over the literature using electronic databases as; MEDLINE, and EMBASE for studies involving data on treatment hypothyroidism in primary care by family doctors, published in English language up to 2018. Hypothyroidism is dealt with by recommending an oral thyroid hormone preparation (typically levothyroxine, a T4 preparation). The dosage should suffice enough to recover regular thyroid hormone levels without creating poisoning from receiving too much of thyroid hormone. TSH levels are monitored to help optimize the dose of T4. TSH is created by the pituitary gland in reaction to thyroid hormone degrees. So when thyroid hormonal agent degrees are reduced (as in hypothyroidism), TSH levels respond by enhancing, in an effort to "whip" a lot more thyroid hormone out of the thyroid gland. When hypothyroidism is adequately dealt with, TSH levels generally drop back down into the typical range. So, a mainstay in identifying the best dosage of T4 is measuring TSH degrees.