Cited by 427Thyroid Disorders and TreatmentsClinical practice guidelines implementationThyroid and Parathyroid Surgery

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Treatment Guidelines for Patients With Hyperthyroidism and Hypothyroidism

Singer, Peter A.·1995·JAMA: The Journal of the American Medical Association

DOI 10.1001/jama.1995.03520340064038

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Abstract

Objective To develop a set of minimum clinical guidelines for use by primary care physicians in the evaluation and management of patients with hyperthyroidism and hypothyroidism. Participants Guidelines were developed by a nine-member ad hoc Standards of Care Committee of the American Thyroid Association (the authors of this article). The participants were selected by the committee chair and the president of the American Thyroid Association on the basis of their clinical experience. The committee members represented different geographic areas within the United States, in order to take into account different practice styles. Evidence Guidelines were developed on the basis of expert opinion of the participants, as well as on available published information. Consensus process Input was obtained from all of the participants, each of whom wrote an initial section of the document. A complete draft document was then written by three participants (P.A.S., D.S.C., and E.G.L.) and resubmitted to the entire committee for revision. The revised document was then submitted to the entire membership of the American Thyroid Association for written comments, which were then reviewed (mainly by P.A.S., D.S.C., and E.G.L.). Many of the suggestions of the American Thyroid Association members were incorporated into the final draft, which was then approved by the Executive Council of the American Thyroid Association. The entire process, from initial drafts to final approval, took approximately 18 m…

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Fatigue in male lymphoma survivors differs between diagnostic groups and is associated with latent hypothyroidism
Kiserud, C., Seland, M., Holte, H., Fosså, A., Fosså, S., Bollerslev, J., Bjøro, T., & Loge, J. (2015) · Acta oncologica · doi:10.3109/0284186x.2014.948057 · Cited by 14
“It is known that fatigue/tiredness might be a symptom of overt hypothyroidism [25].”
Background
Occult Pulmonary Hemorrhage as a Rare Presentation of Propylthiouracil-Induced Vasculitis
Tu, Y.-L., Tsai, Y.-C., Huang, J.-L., & Yao, T. (2011) · Pediatrics · doi:10.1542/peds.2010-0138 · Cited by 14
Long-Term Immunological Study in Graves’ Disease Treated with Thyroid Arterial Embolization
Zhao, W., Gao, B., Jin, C.-Z., Yi, G.-F., Yang, H.-Y., Li, H., Song, D.-P., Hu, J.-H., & Jiang, Y.-N. (2008) · Journal of Clinical Immunology · doi:10.1007/s10875-008-9209-0 · Cited by 14
“Current therapies for GD include antithyroid drugs, radioiodine, and surgery [20–22], and these three treatment modalities are effective in alleviating hyperthyroidism and can result in the inhibition of thyroid hormone synthesis, destruction, and removal of thyroid tissue, respectively.”
Background
Patient Assessment in the Diagnosis, Prevention, and Treatment of Osteoporosis
Lata, P. F., & Elliott, M. E. (2007) · Nutrition in Clinical Practice · doi:10.1177/0115426507022003261 · Cited by 13
Bioequivalence of levothyroxine preparations for treatment of hypothyroidism.
Spigelman, M. (1997) · Journal of the American Medical Association (JAMA) · doi:10.1001/jama.1997.03540390029019 · Cited by 14
Oxidative stress in patients with thyroidectomy and thyroparathyroidectomy under replacement therapy
Kaçmaz, M., Atmaca, M., Arslan, A., Demir, H., & Ozbay, M. F. (2014) · Endocrine · doi:10.1007/s12020-014-0270-6 · Cited by 10
“Current guidelines recommend the use of levothyroxine in the follow-up of total thyroidectomy cases and levothyroxine, calcium, and calcitriol in the follow-up of total thyroidectomy plus surgical hypoparathyroidism cases [13, 14].”
Background
Avaliação da radioiodoterapia com doses fixas de 10 e 15 mCi em pacientes com doença de graves
Canadas, V., Vilar, L., Moura, E., Brito, A., & Castellar, Ê. (2007) · Arquivos Brasileiros de Endocrinologia & Metabologia · doi:10.1590/s0004-27302007000700008 · Cited by 12
Study of Clinicobiochemical Spectrum of Hypothyroidism.
Sampath, S., Singh, P., Somani, B. L., Arora, M., Batra, H., Harith, A., & Ambade, V. (2007) · Medical Journal Armed Forces India · doi:10.1016/s0377-1237(07)80142-0 · Cited by 13
“This is in accordance with the American Academy of Clinical Endocrinologists guidelines which state that appropriate laboratory evaluation with a sensitive TSH test should always be used as the standard criterion for confirming the diagnosis [8].”
Result
Management of Thyroid Cancer and Related Nodular Disease
Mcdougall, I., & Berry, G. (2005) · Springer eBooks · doi:10.1007/b136168 · Cited by 13
An evaluation of the adequacy of outpatient monitoring of thyroid replacement therapy.
Stelfox, H., Ahmed, S. B., Fiskio, J., & Bates, D. (2004) · Journal of Evaluation In Clinical Practice · doi:10.1111/j.1365-2753.2003.00461.x · Cited by 13
Assessment of Thyroid Function in Idiopathic Pulmonary Hypertension
Vakilian, F., Attaran, D., Shegofte, M., Lari, S., & Ghare, S. (2016) · Research in Cardiovascular Medicine · doi:10.5812/cardiovascmed.29361 · Cited by 12
“Associations between thyroid disorders (“hypo” or “hyper”) and pulmonary hypertension have been reported in many cases, (10) and treatment leads to the modification of pulmonary hypertension (11, 12).”
Background
Antithyroid medications and psychosis
Vita, R., Mazzi, V., Antonelli, A., & Benvenga, S. (2013) · Expert Opinion on Drug Safety · doi:10.1517/14740338.2013.823397 · Cited by 9
“The most common cause of hyperthyroidism in the United States is Graves’ disease, followed by toxic multinodular goiter and toxic adenoma [27].”
Background
Modern approach to surgical intervention of the thyroid and parathyroid glands.
Harris, R., Ryu, H., Vu, T., Kim, E., Edeiken, B., Grubbs, E., & Perrier, N. (2012) · Seminars in ultrasound, CT, and MR · doi:10.1053/j.sult.2012.01.005 · Cited by 12
Development and validation of an inductively coupled plasma mass spectrometry method for quantification of levothyroxine in dissolution studies.
Pabla, D., Akhlaghi, F., Ahmed, A., & Zia, H. (2008) · Rapid Communications in Mass Spectrometry · doi:10.1002/rcm.3457 · Cited by 12
Is annual surveillance of all treated hypothyroid patients necessary?
Viswanath, A., Avenell, A., Philip, S., Acharya, S., Maclennan, G., Dalziel, K., Pereira, O., Copland, S. A., Bevan, J., & Abraham, P. (2007) · BMC Endocrine Disorders · doi:10.1186/1472-6823-7-4 · Cited by 12
The Athlete with Fatigue
Moeller, J. L. (2004) · Current Sports Medicine Reports · doi:10.1007/s11932-996-0004-5 · Cited by 7
Lipid Profile Alterations in Subclinical Hypothyroidism
Cabral, M., Costa, A. J., dos Santos, M. J. C. F., & Vaisman, M. (2004) · doi:10.1097/01.ten.0000127928.08840.b7 · Cited by 12
Tratamento do hipertireoidismo da Doença de Graves
Andrade, V. A., Gross, J. L., & Maia, A. L. (2001) · Arquivos Brasileiros de Endocrinologia & Metabologia · doi:10.1590/s0004-27302001000600014 · Cited by 9
Cardio-Thyrotoxicosis Syndrome: A Review of Thyrotoxic Cardiovascular Disease
Bhattad, P., & Roumia, M. (2023) · Cureus · doi:10.7759/cureus.37659 · Cited by 11

Authors: Singer, P. A.
Affiliations: University of Southern California (US)
Corresponding author: Singer, Peter A.
Venue: JAMA: The Journal of the American Medical Association
Publisher: American Medical Association (AMA)
Published: 1995-03-08
Volume: 273
Issue: 10
Pages: 808
ISSN: 0002-9955 (ISSN-L)
0098-7484
DOI: 10.1001/jama.1995.03520340064038
OpenAlex: W2011275871
Cited by: 427
References: 0
Citations by year: 2026: 2 · 2025: 6 · 2024: 7 · 2023: 13 · 2022: 16 · 2021: 13 · 2020: 11 · 2019: 13 · 2018: 11 · 2017: 8 · 2016: 11 · 2015: 9 · 2014: 16 · 2013: 16 · 2012: 27
FWCI: 11.50
Type: journal article
Language: en
Open access: closed
Locations: JAMA (publishedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
Keywords: hyperthyroidism, hypothyroidism, thyroid dysfunction, diagnosis, treatment, primary care, consensus recommendations, American Thyroid Association

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Treatment Guidelines for Patients With Hyperthyroidism and Hypothyroidism

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