Discover and read the best of Twitter Threads about #Hypothyroidism

Most recents (11)

T3 testing is not routinely needed in managing patients with primary #hypothyroidism

1. Primary hypothyroidism is a common hormonal disorder, which is treated with levo-thyroxine (T4) replacement.
#MedTwitter #endocrinology
2. In order to assess the adequacy of T4 dose, some clinicians routinely order #T3 along with #T4 and #TSH (thyroid stimulating hormone). Is routine T3 testing really needed in cases of primary hypothyroidism?
3. Clinician would be able to determine the adequacy or over-replacement of levo-thyroxine (T4) dose on the basis of T4 and TSH levels.
*In cases of over-replacement, T4 will be elevated and TSH suppressed.
*In cases of adequate dosing of T4, TSH and T4 levels would be normal.
Read 6 tweets
I had a difficult time convincing a patient with newly diagnosed Primary Hypothyroidism that she needs to be started on LEVOTHYROXINE asap. Her main concern, similar to many other patients, was that,“Once I start medication, I will have to continue for life.” 1/5
#Hypothyroidism Image
Yes, it’s true that Levothyroxine needs to be taken life-long in patients with autoimmune condition - Hashimoto’s thyroiditis. But the reason is not that - once you start, you won’t be able to stop. Similar logic is used with Insulin. 2/5
Levothyroxine or Insulin do not have addiction potential. It’s not akin to cocaine. You don’t have to take it because some doctor started you on this medication and your body has become “addicted” to it. You have to take it because your body requires it! 3/5
Read 6 tweets
1/n A fascinating article came out this summer that argues for a plant-forward omni diet, and it contains a very inflammatory headline:

"Debunking the #vegan myth: The case for a plant-forward omnivorous whole-foods diet"

Note author Loren Cordain, a paleo proponent Image
2/n

The abstract:

"Veganism is without evolutionary precedent in Homo sapiens species. Strict adherence to a #vegan diet causes predictable deficiencies in nutrients including vitamins B12, B2, D, niacin, iron, iodine, zinc, high-quality proteins, omega-3, and calcium."
3/n

Let's review the images quickly because they show some of these dangers.

Fig. 1. Hazard ratios for all-cause mortality as calculated by Cox proportional hazards multi-variable regression analysis16. P = 0.082.

All cause mortality for #vegans and vegetarians is higher! Image
Read 17 tweets
Thyroid hormones regulate liver enzymes via thyroid hormone receptors. When the liver is steatotic, hepatic thyroid hormone receptors don’t respond effectively. This results in an intrahepatic hormonal milieu where the liver is essentially hypothyroid. #livertwitter #endotwitter
Thyroid hormone receptor-β plays a key role in hepatic homeostasis including:
✅De novo lipogenesis
✅Fatty acid β-oxidation
✅Mitophagy
✅Mitochondrial biogenesis
✅Cholesterol metabolism
✅Carbohydrate metabolism
#livertwitter #endotwitter
Thyroid hormone receptor-β agonism has demonstrated clinical benefits on hepatic lipid metabolism.
frontiersin.org/articles/10.33…
Read 12 tweets
Thyroid hormones regulate liver enzymes. When the liver is fatty, thyroid hormones don’t work right. #HepaticHypothyroidism
Hepatic enzymes responsive to #thyroid hormones will slow down when the liver is fatty. Thyroid hormone has a dominant effect on HMG-CoA reductase in the liver which regulates cholesterol levels which is why #hypothyroidism causes high cholesterol. #HepaticHypothyroidism
Thyroid hormone regulates fatty acid β-oxidation in the liver. This is a process that breaks down fat for energy. #NAFLD impedes the process in a viscous cycle where liver fat continues to build up, energy levels plummet, unresponsive to thyroid hormone. #HepaticHypothyroidism
Read 10 tweets
Thyroid peroxidase (TPO) is an enzyme localized in the normal thyroid gland. TPO plays an important role in the production of thyroid hormones. A TPO antibody test detects antibodies against TPO.

TPO antibodies are checked in patients having primary hypothyroidism 1/n
to help establish underlying etiology. If TPO antibodies are positive, it suggests cause is autoimmune (eg. Hashimoto’s disease).
Some people with positive TPO antibodies may have normal thyroid function. It means that they are at risk of future thyroid dysfunction 2/n
It is normally required to measure TPO Antibody only once when trying to find the etiology of thyroid dysfunction. The goal of Levothyroxine replacement in primary hypothyroidism is to achieve euthyroidism (normalization of TSH) 3/n
Read 4 tweets
Join us tomorrow for the launch of a new #accredited #tweetorial on the primary care management of #hyperlipidemia covering the relationship between #LDL_C & major #CV events, CV risk categories, recommended LDL-C treatment goals, & oral therapeutic options for lipid-lowering
1) Welcome to a new #tweetorial on the primary care management of #hyperlipidemia. Our returning @cardiomet_CE expert author is dedicated #SoMe education advocate Kevin Fernando, FRCGP FRCP Edin, FAcadMEd MSc Diabetes @drkevinfernando
2a) This is the next instalment of @cardiomet_CE's 10-part #tweetorial foundational series on #lipid management! It is accredited for #CME/CE and intended for #physicians #physicianassociates #nurses #nursepractitioners #pharmacists.
#FOAMed @MedTweetorials #cardiotwitter
Read 45 tweets
Proudly sharing our latest paper on ‘hypothyroidism and exercise intolerance’ that has been published Open Access in @JSportsSci by @tandfonline

tandfonline.com/doi/full/10.10…

Time for a thread 🧵
What started as an exploration to better understand physical activity constraints in patients with treated hypothyroidism, has culminated in valuable data and novel factors that are associated with long-term exercise intolerance in this specific group. 1/ Image
Our latest study showed that moderate-intensity physical activity was lower in patients compared to the general population. 2/ Image
Read 10 tweets
10 common causes of heavy menstrual flow you should know

1. Fibroids
2. Pelvic infections
3. Some drugs
4. Polyps
5. IUCDs
6. Endometriosis
7. Adenomyosis
8. Blood clotting problems
9. Cancers of the womb or cervix
10. Thyroid disease

A thread 🧵

{Share to who needs this!}
If a woman loses more than 80ml of blood in one period, the bleeding is heavy. Heavy periods usually often come with blood clots.

Although methods of quantifying the exact amount of blood loss are not usually accurate, most women know when their period is heavy.
Nearly 20% of women over 30 years have #fibroids.They are of different types & may cause heavy menstrual bleeding.

Treatment of fibroids depends on the many factors so see your doctor.
Read 15 tweets
Tweetorial on our new paper, part 1: #Thyrotropin (#TSH) concentration is elevated in post-traumatic stress disorder (#PTSD), reflecting an elevated #setpoint of #pituitary-#thyroid feedback control. doi.org/10.3389/fendo.…
2 | TSH correlates to #allostatic load, measured by #SIQALS 2 score. Although #TSH rises, #FT4 and #FT3 concentration don't go down. Therefore, TSH doesn't reflect #hypothyroidism, but an increased setpoint due to type 2 #allostasis. frontiersin.org/articles/10.33…
3 | #Jostel's TSH index (#JTI) correlates to the #SIQALS 2 score for type 2 #allostatic_load in a large dataset of the #NHANES collective. This supports an elevated reference input (set point) of #thyroid #homeostasis in chronic #stress. doi.org/10.3389/fendo.…
Read 6 tweets
9 common causes of heavy menstrual bleeding everyone should know

1. Fibroids
2. Pelvic infections
3. Drugs
4. Polyps
5. IUCDs
6. Endometriosis
7. Blood clotting problems
8. Cancers of the womb or cervix
9. Thyroid disease

A thread 🧵

{Share for awareness!}
If a woman loses more than 80ml of blood in one period, the bleeding is heavy.

Although methods of quantifying the exact amount of blood loss are not usually accurate, most women know when their period is heavy & heavy usually often come with blood clots.
1
Nearly 20% of women over 30 years have #fibroids.

They are of different types & may cause heavy menstrual bleeding.

Treatment depends on the many factors. So see your doctor. Source: National Health Service, Fibroids, United Kingdom,
Read 14 tweets

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