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.

Dr Watt can be contacted via the main NDDH switchboard (01271 322577) or secretary (01271 322417).

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 RH8.DiabetesAdvice@nhs.net.

 

Home > Formulary > Chapters > 6. Endocrine > Management of thyroid disorders

 

  • First line
  • Second line
  • Specialist
  • Hospital