Hypothyroidism The main cause of uncontrolled TSH is non-adherence to treatment

Compliance assessment is more cost-effective.

Dr. Michelle Mangoal, an endocrinologist and part of the Puerto Rican Society of Endocrinology and Diabetes (SPED). Photo: Journal of Medicine and Public Health.

A study based on the evaluation of a series of cases showed that non-adherence to treatment for hypothyroidism, as well as malabsorption of the drug, and malabsorption, appear as the most common cause of low TSH levels in patients being treated for this condition.

Hypothyroidism occurs when the thyroid gland does not produce enough thyroid hormones to meet the body’s needs. It is one of the most common endocrine disorders and treatment is widely available. However, a minority of patients remain uneven in the gland despite treatment.

According to the authors of the study that included Dr. Michelle MangwalAnd the Endocrinologist s Part of the Puerto Rican Endocrine Society and SPED, non-adherence is often considered a diagnosis of exclusion.

However, the diagnosis of therapeutic malabsorption requires further study, including imaging and invasive procedures, which increase health care costs and the financial burden on the patient.

Analysis of patients’ cases by the research team demonstrated suppression of TSH values ​​and normalization of T4 levels with levothyroxine treatment once a week for a six-week study period.

The third patient described was able to achieve suppressive TSH levels at week 3, along with elevated T4 levels, indicative of adequate levothyroxine absorption.

Similarly, the TSH concentration increased and remained above the normal range, which is attributed to the interruption of study continuity due to Hurricane Maria in Puerto Rico.

The fourth patient described in the case series was presented with TSH suppression at week 3, along with elevated T4, despite levothyroxine.

Weight-calculated doses were started, and TSH and T4 levels were adjusted at the end of the 6-week follow-up period.

We concluded that non-adherence to medical treatment was the most likely cause of low TSH values ​​in those patients who took doses higher than those recommended according to their weight, the researchers noted.

In most cases, a complete medical history and physical examination, including medication history and BMI percentage, are sufficient to determine the cause of uncontrolled hypothyroidism despite high-dose thyroid hormone replacement therapy.

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