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Research ArticleOriginal Article

Prevalence of Iatrogenic Hyperthyroidism in a Community Hospital

Jay G. Watsky and Mark A. Koeniger
The Journal of the American Board of Family Practice May 1998, 11 (3) 175-179; DOI: https://doi.org/10.3122/15572625-11-3-175
Jay G. Watsky
From the 96th Medical Operations Squadron, Eglin Air Force Base, Fla (JGW, MAK).
MD
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Mark A. Koeniger
From the 96th Medical Operations Squadron, Eglin Air Force Base, Fla (JGW, MAK).
MD
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Abstract

Background: There is wide agreement that thyroid hormone replacement should not be given in doses sufficient to suppress thyroid-stimulating hormone (TSH). The purpose of our study was to determine the prevalence of patients currently taking levothyroxine who have an inappropriately suppressed TSH and are thereby at risk for complications of overt or subclinical hyperthyroidism. Those complications of particular concern are osteoporosis and cardiac toxicity, specifically atrial dysrhythmias and development of left ventricular hypertrophy.

Methods: The charts of all 1652 patients dispensed levothyroxine in 1994 from an Air Force community hospital were selected for review. Of these, 905 patients had an available TSH measurement for the same calendar year, and their status was evaluated further.

Results: Of 905 patients, 110 (12.2 percent) had TSH levels ofless than 0.1 μU/mL; 63 (7 percent) had no indication for suppression, and 21 (2.5 percent) were overtly thyrotoxic. The odds ratio for inappropriate suppression in women was 2.83 (95 percent CI 1.05 - 7.68).

Conclusion: The frequent use of levothyroxine suggests that TSH suppression could represent a serious public health concern, particularly for postmenopausal women and patients with heart disease.

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The Journal of the American Board of Family     Practice: 11 (3)
The Journal of the American Board of Family Practice
Vol. 11, Issue 3
1 May 1998
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Prevalence of Iatrogenic Hyperthyroidism in a Community Hospital
Jay G. Watsky, Mark A. Koeniger
The Journal of the American Board of Family Practice May 1998, 11 (3) 175-179; DOI: 10.3122/15572625-11-3-175

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Prevalence of Iatrogenic Hyperthyroidism in a Community Hospital
Jay G. Watsky, Mark A. Koeniger
The Journal of the American Board of Family Practice May 1998, 11 (3) 175-179; DOI: 10.3122/15572625-11-3-175
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