The Diagnosis and Management of Hypothyroidism

Bhuvana Guha, MD, Guha Krishnaswamy, MD, And Alan Peiris, MD, PhD, MRCP


South Med J. 2002;95(5):475-480. 

In This Article


Hypothyroidism refers to a metabolic state resulting from a deficiency in thyroid hormone function. It usually arises from primary thyroid disease, but in rare cases it is due to hypothalamic-pituitary disease or generalized tissue resistance to thyroid hormone.[1] The manifestations of hypothyroidism are well described and can affect virtually any organ. The early recognition of hypothyroidism remains a challenge, especially when the decline in thyroid function is gradual. In some instances, the manifestations of hypothyroidism may be erroneously attributed to the effects of aging in the elderly. Clinical suspicion of hypothyroidism justifies laboratory testing. Screening for abnormalities in thyroid function is recommended by several medical professional organizations; however, the criteria for screening remains controversial. In the presence of conditions which increase the risk of hypothyroidism, a more intensive stance on screening may be justified. The criteria for screening are listed in Table 1 .