The DOI matches its Crossref record; 160 of the 163 references it cites were found in a registry or an index.
Hypothyroidism
Abstract
Hypothyroidism is common, potentially serious, often clinically overlooked, readily diagnosed by laboratory testing, and eminently treatable. The condition is particularly prevalent in older women, in whom autoimmune thyroiditis is common. Other important causes include congenital thyroid disorders, previous thyroid surgery and irradiation, drugs such as lithium carbonate and amiodarone, and pituitary and hypothalamic disorders. Worldwide, dietary iodine deficiency remains an important cause. Hypothyroidism can present with nonspecific constitutional and neuropsychiatric complaints, or with hypercholesterolaemia, hyponatraemia, hyperprolactinaemia, or hyperhomocysteinaemia. Severe untreated hypothyroidism can lead to heart failure, psychosis, and coma. Although these manifestations are neither specific nor sensitive, the diagnosis is confirmed or excluded by measurements of serum thyrotropin and free thyroxine. Thyroxine replacement therapy is highly effective and safe, but suboptimal dosing is common in clinical practice. Patient noncompliance, drug interactions, and pregnancy can lead to inadequate treatment. Iatrogenic thyrotoxicosis can cause symptoms, and, even when mild, provoke atrial fibrillation and osteoporosis. We summarise present understanding of the history, epidemiology, pathophysiology, and clinical diagnosis and management of hypothyroidism.
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In the citing paper
“older people often require much lower doses to achieve euthyroidism, and most recommend a reduced dose of 0.5 µg/kg/day in seniors (age >65 years).1 62”
From Levothyroxine dose and risk of fractures in older adults: nested case-control study (2011) · cites this paper as [1]
In the citing paper
“While the optimal levothyroxine dose for adults is 1.6-1.8 µg/kg/day,1 9”
From Levothyroxine dose and risk of fractures in older adults: nested case-control study (2011) · cites this paper as [1]
In the citing paper
“older people often require much lower doses to achieve euthyroidism, and most recommend a reduced dose of 0.5 µg/kg/day in seniors (age >65 years).1 62”
From Levothyroxine dose and risk of fractures in older adults: nested case-control study (2011) · cites this paper as [1]
Citations
Cites
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The Colorado Thyroid Disease Prevalence Study
Canaris, G. J., Manowitz, N. R., Mayor, G., & Ridgway, E. C. (2000) · Archives of Internal Medicine · doi:10.1001/archinte.160.4.526 · Cited by 2,824
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Cited by
Sorted by citations
The Clinical Significance of Subclinical Thyroid Dysfunction
Biondi, B., & Cooper, D. S. (2008) · Endocrine Reviews · doi:10.1210/er.2006-0043 · Cited by 1,418
Prevalence of hypothyroidism in adults: an epidemiological study in eight cities of India.
Unnikrishnan, A., Kalra, S., Sahay, R., Bantwal, G., John, M., & Tewari, N. (2013) · Indian Journal of Endocrinology and Metabolism · doi:10.4103/2230-8210.113755 · Cited by 422
Hypothyroidism as a Risk Factor for Cardiovascular Disease
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Thyroid hormones states and brain development interactions
Ahmed, O. M., El‐Gareib, A. W., El-Bakry, A. M., El-Twab, S. M. A., & Ahmed, R. G. (2007) · International Journal of Developmental Neuroscience · doi:10.1016/j.ijdevneu.2007.09.011 · Cited by 345
A Review of the Clinical Consequences of Variation in Thyroid Function Within the Reference Range
Taylor, P. N., Razvi, S., Pearce, S. H., & Dayan, C. M. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-1315 · Cited by 274
Metadata
- Authors
- Roberts, C. G., & Ladenson, P. W.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Ladenson, Paul W
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2004-03
- Volume
- 363
- Issue
- 9411
- Pages
- 793-803
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W4211152088
- Cited by
- 567
- References
- 163
- Citations by year
- 2026: 8 · 2025: 17 · 2024: 29 · 2023: 22 · 2022: 23 · 2021: 23 · 2020: 22 · 2019: 22 · 2018: 24 · 2017: 29 · 2016: 42 · 2015: 33 · 2014: 32 · 2013: 25 · 2012: 30
- FWCI
- 3.92
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Keywords
- hypothyroidism, autoimmune thyroiditis, thyroid hormone replacement, thyrotoxicosis, lithium, amiodarone, iodine deficiency, hypercholesterolemia, hyperprolactinemia, hyperhomocysteinemia, hyponatremia, heart failure, pregnancy, older women, drug interactions
- MeSH terms
- Humans, Hypothyroidism, Thyroxine, Case-Control Studies, Randomized Controlled Trials as Topic
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