Management of thyroid disorders

Interpretation of biochemical tests

High TSH

  • with high free T4
    • Assay interference
    • ? TSH secreting pituitary tumour
    • ? Thyroid hormone resistance
  • with normal free T4
    • Subclinical hypothyroidism (TSH greater than 4.5 less than 20)
  • with low free T4
    • primary hypothyroidism or thyroiditis (TSH usually greater than 20)

Normal TSH

  • with high free T4
    • Assay interference
    • ? TSH secreting pituitary tumour
    • ? Thyroid hormone resistance
  • with normal free T4
    • Normal
  • with low free T4
    • Sick euthyroid
    • secondary hypothyroidism

Low TSH

  • with high free T4
    • Thyrotoxicosis
    • Thyroiditis
  • with normal free T4
    • Free T3 raised: thyrotoxicosis, thyroiditis
    • Free T3 normal: subclinical hyperthyroidism
  • with low free T4
    • secondary hypothyroidism

North Devon Clinic and Contact Information

Patients are seen in the General Medicine and Endocrinology Clinic every Thursday afternoon.


Exeter Thyroid Clinic

Thursday morning (weekly)

  • Thyrotoxicosis
  • Thyroiditis
  • Difficult hypothyroidism
  • Goitres and nodules

Surgical clinics

  • Miss J Dunn

Combined thyroid eye disease clinic (monthly)

  • Mr A Quinn and Dr B Vaidya

Telephone advice

  • Dr Vaidya, Dr Donohoe, Dr Warren, Dr Brooke or Professor Hattersley (for antenatal) can be contacted 1400-1445, Monday - Friday on 07818 002363.
  • At other times, try direct lines or secretary.

Consultants will also give advice by email. Queries should be sent to rde-tr.diabetesadvice@nhs.net

 

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