October Reading Notes

In October, I read review papers and research articles about ergot alkaloids, prostaglandin receptors, hormonal contraception for men, gonadal cell biology, calling and treating hypothyroidism, and an opinion article advocating for management of low-risk obstetric patients in well-equipped outpatient birthing centers.

Here are the highlights and take-aways:

Garber JR, Cobin RH, Gharib H, et al. Clinical Practice Guidelines for Hypothyroidism in Adults: Cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Thyroid. 2012;22(12):1200-1235. doi:10.1089/thy.2012.0205.

When you check a serum thyrotropin (TSH) with a reflex to free T4 on a patient in the setting of working up other presentations, you may discover subclinical hypothyroidism. The American Association of Clinical Endocrinologists and the American Thyroid Association shares their recommendations in this 2012 practice guideline. The key question for me was, when do we start thyroid hormone supplements/replacement for patients with subclinical hypothyroidism?

Here was their answer:

  • serum thyrotropin (TSH) levels greater than 10 mIU/L merit replacement therapy
  • individualize for patients with any less