CME | A Crash Course in Thyroid Confusion

About this episode

This episode provides a practical approach to understanding and managing hypothyroidism through case studies and key thyroid testing insights.

In this episode of CME On the GO, the hosts discuss a practical approach to hypothyroidism, using a case of a 50-year-old woman with nonspecific symptoms (weight gain, fatigue, edema, constipation). They emphasize thorough history and physical exam , then outline key thyroid testing: TSH as the initial screening test (often with reflex free T4), free T4 for confirmation and special situations (including pregnancy), and limited uses for T3 tests. They review antibody testing (TPO for Hashimoto's, thyroglobulin antibodies in select cases) and note tests for Graves disease outside this episode. They cover sick thyroid considerations, subclinical hypothyroidism controversy, pregnancy management with tighter TSH goals and dose increases, and treatment preferences favoring standardized levothyroxine over desiccated thyroid, with limited/controversial use of combination T4/T3 therapy. Learning Objectives Interpret key thyroid laboratory tests—including TSH, T4, fT4, T3, fT3, and thyroid antibodies—within the framework of thyroid physiology and the hypothalamic-pituitary-thyroid axis. Compare the efficacy, safety, and clinical indications of thyroid hormone replacement options such as…

Topics covered

• hypothyroidism
• thyroid testing
• thyroid hormone replacement
• subclinical hypothyroidism
• patient management

Keywords

• hypothyroidism
• TSH
• thyroid testing
• levothyroxine
• subclinical hypothyroidism
• thyroid antibodies
• patient scenarios

Mentioned in this episode

Organizations: American Academy of Family Physicians

Products: levothyroxine, liothyronine (Cytomel), desiccated thyroid

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