The Hypothyroid Patient – Nurse Practitioner
About 12% of the US population has some form of thyroid disease, and more than half of them are unaware of their condition. Hypothyroidism is the most common thyroid condition. It affects about 2% of women and 0.1-0.2% of men; however, in adults over 60 years old, 6% of women and 2.5% of men have the condition. Hypothyroidism is a chronic disease that requires lifelong treatment; fortunately, it can be easily managed with thyroid hormone replacement medication.3 The recommended treatment is levothyroxine, which was the most frequently prescribed drug in the US in 2019.4 Other thyroid hormone replacement medications are available in various products and strengths, which can be cause of confusion for healthcare providers and patients. Choosing the correct product and dose requires a full understanding of the disease and the treatments. Healthcare providers should be able to provide evidence-based recommendations, taking into consideration a patient's age, concurrent medical conditions, and other medications. This issue will review the pathophysiology and clinical features of hypothyroidism, as well as drug therapy considerations. Treatment strategies for older adults, children, and pregnant women are summarized. Subclinical hypothyroidism is also discussed.