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Postpartum Thyroiditis. Falls Church, VA: American Thyroid Association. 2005. 1 p.

This fact sheet answers common questions about postpartum thyroiditis, an inflammation of the thyroid that occurs in women after the delivery of a baby. Thyroiditis can cause both thyrotoxicosis, which is high thyroid hormone levels in the blood, and hypothyroidism, which is low thyroid hormone levels in the blood. The normal pattern in postpartum thyroiditis is thyrotoxicosis, followed by hypothyroidism. Topics covered include the causes of postpartum thyroiditis, the role of the immune system, the incidence of postpartum thyroiditis in the United States, risk factors for developing postpartum thyroiditis, the clinical course of the condition, and treatment options, which vary depending on the phase of thyroiditis and the degree of symptoms that patients exhibit. The author stresses that it is important to try to discontinue thyroid hormone after postpartum thyroiditis because 80 percent of patients will regain normal thyroid function and not require chronic therapy after approximately 6 to 12 months. Readers are referred to the American Thyroid Association (www.thyroid.org) for more information.

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Thyroid And Weight. Falls Church, VA: American Thyroid Association. 2005. 2 p.

A complex relationship exists between thyroid disease, body weight, and metabolism. This fact sheet answers common questions about this relationship and discusses the diagnostic tests used to measure metabolism, the use of the basal metabolic rate (BMR), the relationship between BMR and weight, energy balance and caloric intake, the role of other hormones besides the thyroid hormone, the relationship between hyperthyroidism and weight, weight gain during treatment for hyperthyroidism, weight loss after hypothyroidism if appropriately treated, and the use of thyroid hormones as a weight loss tool. Readers are referred to the American Thyroid Association (www.thyroid.org) for more information.

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Thyroid Disease and Pregnancy. Falls Church, VA: American Thyroid Association. 2005. 3 p.

This fact sheet reviews thyroid disease and pregnancy. Written in nontechnical language, the fact sheet answers common questions about thyroid function, hyperthyroidism and pregnancy, and hypothyroidism and pregnancy. Specific topics include the normal changes in thyroid function associated with pregnancy, the interaction between the thyroid function of the mother and the baby, the most common causes of hyperthyroidism during pregnancy, the risks of Graves’ disease to the mother and to the baby, treatment options for a pregnant woman with Graves’ disease, breastfeeding while on anti-thyroid drugs, the most common causes of hypothyroidism during pregnancy, the risks of hypothyroidism to the mother and the fetus, and treating hypothyroidism in a pregnant woman. Readers are referred to the American Thyroid Association website (www.thyroid.org) for additional information. The fact sheet is also available in Spanish. 1 table.

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Thyroid Disease in the Older Patient. Falls Church, VA: American Thyroid Association. 2 p. 2005.

This fact sheet answers common questions about thyroid disease in older adults. The fact sheet first presents brief synopses of symptoms in six representative older adults; three adults’ symptoms are due to hyperthyroidism and three to hypothyroidism. All six patients presented with different symptoms. The author notes that an important clue to the presence of thyroid disease in an older adult is a history of thyroid disease in another close family member. The fact sheet discusses the diagnosis and treatment of hyperthyroidism, and the diagnosis and treatment of hypothyroidism. The author concludes by cautioning that despite the increased frequency of thyroid problems in older adults, physicians need a high index of suspicion to make the diagnosis because thyroid disorders often look like a disorder of another system in the body. Readers are referred to the American Thyroid Association (www.thyroid.org) for more information.

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Thyroid Function Tests. Falls Church, VA: American Thyroid Association. 2005. 2 p.

This fact sheet reviews thyroid function tests, which are used to diagnose thyroid problems and monitor patients receiving medication for thyroid problems. Written in nontechnical language, the fact sheet answers common questions about the anatomy and function of the thyroid gland, and the tests used to evaluate thyroid function. Specific tests discussed include TSH tests, T4 tests, T3 tests, thyroid antibody tests, radioactive iodine uptake, and thyroid scan. A figure illustrates the normal interplay between the thyroid and pituitary glands, as well as how it is changed in hyperthyroidism and hypothyroidism. Readers are referred to the American Thyroid Association website (www.thyroid.org) for additional information. 1 figure.

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Thyroiditis. Falls Church, VA: American Thyroid Association. 2005. p.

This fact sheet answers common questions about thyroiditis, a general term that means inflammation of the thyroid gland. The author notes that thyroiditis includes a group of individual disorders that all cause thyroidal inflammation and thus create many different clinical presentations. The fact sheet discusses the clinical symptoms of thyroiditis, including hypothyroidism, thyrotoxicosis, and hyperthyroidism; the causes of thyroiditis, including autoimmune disease, infection, and medications; the typical clinical course of different types of thyroiditis, including Hashimoto’s thyroiditis, painless and postpartum thyroiditis, subacute thyroiditis, drug-induced and radiation thyroiditis, and acute or infectious thyroiditis; and treatment options, including those for thyrotoxicosis, hypothyroidism, and thyroidal pain. Readers are referred to the American Thyroid Association (www.thyroid.org) for more information. The fact sheet is also available in Spanish. 1 table.

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Endocrinology. New York, NY: Elsevier Science, Inc. 2003. 737 p.

This book on endocrinology is from a series that provides the latest on evaluation, diagnosis, management, outcomes and prevention. The book offers concise, action-oriented recommendations for primary care medicine. It includes MediFiles (sections) on acromegaly, Addison's disease (hypoaldosteronism), Cushing's syndrome, diabetes insipidus, type 1 diabetes mellitus, type 2 diabetes mellitus, diabetic ketoacidosis, Gilbert's disease, gynecomastia, hirsutism, hypercalcemia, hyperkalemia, hyperthyroidism, hypocalcemia, hypokalemia, hyponatremia, hypopituitarism, hypothyroidism, Klinefelter's syndrome, osteomalacia and rickets, osteoporosis, pheochromocytoma, polycystic ovarian syndrome, precocious puberty, thyroid carcinoma, thyroid nodule, thyroiditis, and Turner's syndrome. Each MediFile covers summary information and background on the condition, and comprehensive information on diagnosis, treatment, outcomes, and prevention. Each section concludes with a list of resources.

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Hyponatremia: How to Recognize the Cause Promptly and Avoid Treatment Pitfalls. Consultant. 43(7): 861-865, 869-870. June 2003.

This article discusses the diagnosis and treatment of hyponatremia (low levels of sodium in the blood). The authors recommend that to identify the cause of hyponatremia, the physician should determine the patient's volume status and measure urinary sodium and osmolality, and also ask about diuretic use. Hypovolemic hyponatremia is associated with vomiting, diarrhea, laxative abuse, renal disease, nasogastric suction, salt-wasting nephropathy, Addison disease, solute diuresis, and diuretic use. Euvolemic hyponatremia with a normal urinary sodium level can result from glucocorticoid deficiency, hypothyroidism, certain drugs, and the syndrome of inappropriate antidiuretic hormone secretion. Euvolemic hyponatremia with low urinary osmolality can be caused by psychogenic polydipsia, 'tea and toast' syndrome, or beer potomania. Hypervolemic hyponatremia is associated with congestive heart failure, nephrotic syndrome, and cirrhosis. The article includes two patient care algorithms. 2 figures. 10 references.

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Williams Textbook of Endocrinology. 10th ed. St. Louis, MO: Elsevier, Health Sciences Division. 2003. (CD-ROM)

This textbook of endocrinology serves as a bridge between basic science and clinical endocrinology. Forty-one chapters are provided in ten sections: hormones and hormone action, hypothalamus and pituitary, thyroid, adrenal, reproduction, endocrinology and the life span, mineral metabolism, disorders of carbohydrate and lipid metabolism, polyendocrine disorders, and paraendocrine and neoplastic syndromes. Specific topics include: principles of endocrinology; the endocrine patient; genetic control of peptide hormone formation; mechanism of action of hormones that act as nuclear hormone receptors; mechanism of action of hormones that act at the cell surface; laboratory techniques for recognition of endocrine disorders; neuroendocrinology; the anterior pituitary; the posterior pituitary; thyroid physiology and diagnostic evaluation of patients with thyroid disorders; thyrotoxicosis; hypothyroidism and thyroiditis; nontoxic goiter and thyroid neoplasia; the adrenal cortex; endocrine hypertension; the physiology and pathology of the female reproductive axis; fertility control: current approaches and global aspects; disorders of the testes and the male reproductive tract; sexual dysfunction in men and women; endocrine changes of pregnancy; endocrinology of fetal development; disorders of sex differentiation; normal and aberrant growth; puberty: ontogeny, neuroendocrinology, physiology, and disorders; endocrinology and aging; hormones and disorders of mineral metabolism; metabolic bone disease; kidney stones; type 2 diabetes mellitus; type 1 diabetes mellitus; complications of diabetes mellitus; glucose homeostasis and hypoglycemia; obesity; disorders of lipid metabolism; pathogenesis of endocrine tumors; multiple endocrine neoplasias; the immunoendocrinopathy syndromes; gastrointestinal hormones and gut endocrine tumors; endocrine-responsive cancer; humoral manifestations of malignancy; carcinoid tumors, carcinoid syndrome, and related disorders. Each chapter is written by experts in the field and concludes with extensive references; a subject index concludes the textbook. The CD-ROM format enables powerful search capabilities, as well as links to MEDLINE abstracts for many of the references.

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Diabetes and Thyroid Disease: A Likely Combination. Diabetes Spectrum. 15(3): 140-142. 2002.

In this article, the authors present a case of a 70 year old woman with type 2 diabetes who is diagnosed with thyroid disease (hypothyroidism). The authors discuss the likelihood of hypothyroidism in elderly women, the possibility of hypothyroidism as a strong risk factor for cardiovascular disease (CVD), the benefits of treating subclinical hypothyroidism, the prevalence of subclinical hypothyroidism, the prevalence of thyroid disease in patients with diabetes, symptoms of subclinical hypothyroidism, dyslipidemia, the interplay between blood glucose levels and hypothyroidism, insulin resistance and hypothyroidism, and recommended interventions. 9 references.

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