Episode Details

🚨 www.tadeclinicagem.com.br/guia - Conheça o Guia TdC com 7 dias grátis 🚨

Rapha e João batem um papo sobre Hipotireoidismo com a Dra Nathalie Santana, clínica pela UNIFESP/EPM, endocrinologista pela HCFMUSP e professora da UNIT (Universidade Tiradentes) e UFS (Universidade Federal do Sergipe). 

Leia também o tópico do Guia TdC: https://www.tadeclinicagem.com.br/guia/358/hipotireoidismo-subclinico/

Minutagem

(1:40) Apresentação da convidada Dra. Nathalie Santana

(2:50) Ressalva do episódio dio

(3:30) Exames do hipotireoidismo - anti TPO e anti- tireoglobulina

(5:50) Drogas e hipotireoidismo

(8:00) Quadro clínico

(9:13) Obesidade e tireoide

(10:55) anemia, hiponatremia, miopatia e sd de aprisionamento de nervo

(15:08) Quais exames solicitar?

(18:53) Sd do eutiroideu doente

(20:00) Biotina nos exames laboratoriais

(21:24) O que não precisa pedir

(22:00) Tratamento

(23:43) Dose inicial

(26:54) Cuidados nos idosos

(28:45) Relação levotiroxina e peso

(30:26) Orientações sobre levotiroxina

(32:38) Fatores que alteram a absorção

(34:25) Situações maleáveis

(36:26) Levotiroxina e estrogênio

(37:20) Último caso

(40:40) Ajuste de dose

(42:24) Metas do TSH

(44:08) Resumo do tratamento + clinicagens

(47:40) Hipotireoidismo subclinico

(48:35) Quando tratar

(48:58) Quando não tratar

(51:11) Porque tratar os jovens

(52:20) Outros casos

(53:20) Como tratar o hipotireoidismo subclínico

(55:55) Salves

(56:30) Desafio da semana anterior

(57:36) Desafio da semana

Referências: 
1- Uptodate 2021. Treatment of primary hypothyroidism in adults. Douglas S Ross., David S Cooper, Jean E Mulder MD. 
2- SANTINI, Ferruccio et al. Lean body mass is a major determinant of levothyroxine dosage in the treatment of thyroid diseases. The Journal of Clinical Endocrinology & Metabolism, v. 90, n. 1, p. 124-127, 2005. 
3- SKELIN, Marko et al. Effect of timing of levothyroxine administration on the treatment of hypothyroidism: a three-period crossover randomized study. Endocrine, v. 62, n. 2, p. 432-439, 2018. 
4- BERNSTEIN, Robert S.; ROBBINS, Jacob. Intermittent therapy with L-thyroxine. New England Journal of Medicine, v. 281, n. 26, p. 1444-1448, 1969. 
5- JONKLAAS, Jacqueline et al. Evidence-Based Use of Levothyroxine/Liothyronine Combinations in Treating Hypothyroidism: A Consensus Document. European Thyroid Journal, v. 10, n. 1, p. 10-38, 2021. 
6- WILDISEN, Lea et al. Effect of Levothyroxine Therapy on the Development of Depressive Symptoms in Older Adults With Subclinical Hypothyroidism: An Ancillary Study of a Randomized Clinical Trial. JAMA network open, v. 4, n. 2, p. e2036645-e2036645, 2021. 
7- STOTT, David J. et al. Thyroid hormone therapy for older adults with subclinical hypothyroidism. New England Journal of Medicine, v. 376, n. 26, p. 2534-2544, 2017. 
8- MOOIJAART, Simon P. et al. Association between levothyroxine treatment and thyroid-related symptoms among adults aged 80 years and older with subclinical hypothyroidism. Jama, v. 322, n. 20, p. 1977-1986, 2019. 
9- BEKKERING, G. E. et al. Thyroid hormones treatment for subclinical hypothyroidism: a clinical practice guideline. Bmj, v. 365, 2019. 
10- Society for Endocrinology & British Thyroid Association issue statement against new treatment recommendations for subclinical hypothyroidism 
11- BIONDI, Bernadette; CAPPOLA, Anne R.; COOPER, David S. Subclinical hypothyroidism: a review. Jama, v. 322, n. 2, p. 153-160, 2019. 
12- JONKLAAS, Jacqueline et al. Guidelines for the treatment of hypothyroidism: prepared by the american thyroid association task force on thyroid hormone replacement. thyroid, v. 24, n. 12, p. 16