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
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 language | English |
|---|---|
| Pages (from-to) | E1274-E1280 |
| Number of pages | 7 |
| Journal | CMAJ |
| Volume | 191 |
| Issue number | 46 |
| DOIs | |
| Publication status | Published - 18 Nov 2019 |
Keywords
- primary care
- asymptomatic thyroid dysfunction
- screening
- screening and diagnostic tests
- family medicine
- general practice
- endocrinology