Recommendation on screening adults for asymptomatic thyroid dysfunction in primary care

Richard Birtwhistle, Kate Morissette, James A. Dickinson, Donna L. Reynolds, Marc T. Avey, Francesca Reyes Domingo, Rachel Rodin, Brett D. Thombs, Canadian Task Force on Preventive Health Care, Heather Colquhoun, Roland Grad, Stéphane Groulx, Scott Klarenbach, Michael Kidd, Christina Korownyk, Eddy Lang, John C. LeBlanc, Ainsley Moore, Navindra Persaud, John J. RivaGuylene Thériault, Brenda J. Wilson

Research output: Contribution to journalReview article

5 Citations (Scopus)

Abstract

KEY POINTS

The Canadian Task Force on Preventive Health Care strongly recommends against screening for thyroid dysfunction in asymptomatic nonpregnant adults.

Screening for thyroid dysfunction in asymptomatic nonpregnant adults is not likely to confer clinical benefit, but could lead to unnecessary treatment for some patients and consume resources.

Treating asymptomatic adults for screen-detected hypothyroidism may result in little to no difference in clinical outcomes.

Clinicians should remain alert to signs and symptoms suggestive of thyroid dysfunction and investigate accordingly.

This guideline from the Canadian Task Force on Preventive Health Care focuses on screening for thyroid dysfunction among asymptomatic nonpregnant adults in primary care beyond usual care and vigilance for signs and symptoms of thyroid dysfunction. Thyroid dysfunction is diagnosed based on abnormal levels of serum thyroid-stimulating hormone (TSH) and can be characterized as either hypo- or hyperthyroidism. Hypothyroidism results from impaired thyroid hormone production (i.e., thyroxine [T4] or triiodothyronine [T3]), leading to elevated levels of TSH. Hypothyroidism is often caused by autoimmune disorders (e.g., Hashimoto thyroiditis) or occurs as a sequela of hyperthyroidism treatment, which can render the thyroid gland nonfunctional.1 Hyperthyroidism results from an overproduction of thyroid hormone, leading to the suppression of TSH.1 Causes of hyperthyroidism include Graves disease, toxic multinodular goitre and toxic adenoma.2
Original languageEnglish
Pages (from-to)E1274-E1280
Number of pages7
JournalCMAJ
Volume191
Issue number46
DOIs
Publication statusPublished - 18 Nov 2019

Keywords

  • primary care
  • asymptomatic thyroid dysfunction
  • screening
  • screening and diagnostic tests
  • family medicine
  • general practice
  • endocrinology

Fingerprint Dive into the research topics of 'Recommendation on screening adults for asymptomatic thyroid dysfunction in primary care'. Together they form a unique fingerprint.

  • Cite this

    Birtwhistle, R., Morissette, K., Dickinson, J. A., Reynolds, D. L., Avey, M. T., Domingo, F. R., Rodin, R., Thombs, B. D., Canadian Task Force on Preventive Health Care, Colquhoun, H., Grad, R., Groulx, S., Klarenbach, S., Kidd, M., Korownyk, C., Lang, E., LeBlanc, J. C., Moore, A., Persaud, N., ... Wilson, B. J. (2019). Recommendation on screening adults for asymptomatic thyroid dysfunction in primary care. CMAJ, 191(46), E1274-E1280. https://doi.org/10.1503/cmaj.190395