000			03014nam a22003857a 4500
008			150313s20142014 xxu||||| |||| 00| 0 eng d
022			_a0163-769X
040			_aOvid MEDLINE(R)
099			_a24433025
245			_aTreatment with thyroid hormone. [Review]
251			_aEndocrine Reviews. 35(3):433-512, 2014 Jun.
252			_aEndocr Rev. 35(3):433-512, 2014 Jun.
253			_aEndocrine reviews
260			_c2014
260			_fFY2014
266			_d2015-03-17
501			_aAvailable online through MWHC library: 1997 -2011, Available in print through MWHC library: 1999 - 2006
520			_aThyroid hormone deficiency can have important repercussions. Treatment with thyroid hormone in replacement doses is essential in patients with hypothyroidism. In this review, we critically discuss the thyroid hormone formulations that are available and approaches to correct replacement therapy with thyroid hormone in primary and central hypothyroidism in different periods of life such as pregnancy, birth, infancy, childhood, and adolescence as well as in adult patients, the elderly, and in patients with comorbidities. Despite the frequent and long term use of l-T4, several studies have documented frequent under- and overtreatment during replacement therapy in hypothyroid patients. We assess the factors determining l-T4 requirements (sex, age, gender, menstrual status, body weight, and lean body mass), the major causes of failure to achieve optimal serum TSH levels in undertreated patients (poor patient compliance, timing of l-T4 administration, interferences with absorption, gastrointestinal diseases, and drugs), and the adverse consequences of unintentional TSH suppression in overtreated patients. Opinions differ regarding the treatment of mild thyroid hormone deficiency, and we examine the recent evidence favoring treatment of this condition. New data suggesting that combined therapy with T3 and T4 could be indicated in some patients with hypothyroidism are assessed, and the indications for TSH suppression with l-T4 in patients with euthyroid multinodular goiter and in those with differentiated thyroid cancer are reviewed. Lastly, we address the potential use of thyroid hormones or their analogs in obese patients and in severe cardiac diseases, dyslipidemia, and nonthyroidal illnesses.
546			_aEnglish
650			_a*Hormone Replacement Therapy/ae [Adverse Effects]
650			_a*Hypothyroidism/dt [Drug Therapy]
650			_a*Thyroid Hormones
650			_aHumans
650			_aThyroid Hormones/ae [Adverse Effects]
650			_aThyroid Hormones/df [Deficiency]
650			_aThyroid Hormones/tu [Therapeutic Use]
651			_aMedStar Washington Hospital Center
656			_aMedicine/Endocrinology
657			_aJournal Article
657			_aReview
700			_aWartofsky, Leonard
790			_aBiondi B, Wartofsky L
856			_uhttp://dx.doi.org/10.1210/er.2013-1083 _zhttp://dx.doi.org/10.1210/er.2013-1083
942			_cART _dArticle
999			_c1560 _d1560