Thyroid disorders

Question 1

What labs represent hypothyroidism? How would you treat it? (2)

Answer 1

Labs: Low FT4-High TSH
Treatment: Levothyroxine (Synthroid, Levoxyl)

Question 2

What labs represent hyperthyroidism/thyrotoxicosis? How do you treat this? (5)

Answer 2

Labs: High FT4-Low TSH
Treatment: PO methimazole (Tapazole) or PTU to reduce thyroxine, Beta blocker for tachycardia tremor (propranolol, nadolol)
Once euthryoid from antithyroid medications, radioactive iodine.
Therapeutic goal=Thyroid ablation with resulting hypothryoidism.

Question 3

Labs and Treatment for subclinical hypothyroidism? (2)

Answer 3

Labs: Elevated TSH, normal FT4
Treatment: Levothyroxine with TSH > 5 if presence of goiter or TPO antibodies, presence of symptoms compatible with hypothyroidism, infertility, pregnancy, etc.

Question 4

If on Levothyroxine therapy and TSH lab comes back high, what do you do with medication? (1)

Answer 4

Increase dose

Question 5

If on Levothyroxine therapy and TSH lab comes back low, what do you do with medication? (1)

Answer 5

Decrease dose