Discover and read the best of Twitter Threads about #endotip

Most recents (2)

🤔 Does metformin cause vitB12 deficiency?

❗️Metformin is the most prescribed drug for type 2 diabetes. Should you monitor vit B12 in pts taking it?

Follow the🧵

#MedTwitter #tweetorial #Endotip
Let's start with a poll. Do you order vit B12 for pts taking metformin?
ADA Standards of Care 2022

"Long-term use of metformin may be associated with biochemical vitamin B12 deficiency; consider periodic measurement of vitamin B12 levels in metformin-treated patients, especially in those with anemia
or peripheral neuropathy."
pubmed.ncbi.nlm.nih.gov/34964876/
Read 12 tweets
Hey #MedTwitter,

An asymptomatic patient came to the outpatient clinic because of low TSH, high fT4/T3, and positive TRAb

Final diagnosis: Biotin supplement use🤔

Follow the 🧵

#Endotip #MedEd
Biotin supplements are commonly used and do not change thyroid function.

On the other hand, biotin often causes lab assay interference mimicking Graves' disease:

⬇️ TSH

⬆️ fT4 and T3

⬆️ TRAb
TRAb is a marker of Graves' disease, the most common cause of thyrotoxicosis/hyperthyroidism, and has a high accuracy :
- Sensitivity: ~ 97%
- Specificity: ~ 99%

📢Beware that despite high reliability, TRAb result can be falsely elevated in the setting of biotin use
Read 5 tweets

Related hashtags

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3.00/month or $30.00/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!