Hypothyroidism: a lecture for primary care physicians

Abstract

The prevalence of hypothyroidism in the population is high. The frequency of manifest hypothyroidism in the world, according to various data, is 0.2–2.0%, subclinical one – up to 10% for women and up to 3% for men, and in the older age group (over 70 years) reaches 14%, with the majority of cases of hypothyroidism accounted for primary hypothyroidism. Thus, a doctor of any specialty in his practice is likely to meet a patient with hypothyroidism: both with the established diagnosis, and face the need for differential diagnosis of various pathological conditions with hypothyroidism. This article presents a classification of hypothyroidism based on etiological aspects, describes the clinical picture of the disease, pays special attention to the so-called «masks» of hypothyroidism, which, in our view, can be useful for a doctor of any specialty, provides available methods for diagnosing this syndrome (special attention is paid to laboratory methods), as well as the goals and principles of treatment, highlights the need to monitor laboratory indicators in dynamics against the background of treatment. In addition, the features of correction of hypothyroidism during pregnancy are given. The article presents the peculiarities of selecting drug doses depending on the patient’s age and comorbidity. The distinctive feature and the purpose of this article, from our point of view, is its potential benefits not only for endocrinologists, but also for other health professionals.

Keywords

• hypothyroidism
• masks of hypothyroidism
• autoimmune thyroiditis
• thyroid-stimulating hormone
• thyroid gland
• treatment