[NP-Clinical] endocrine question

[Patricia Munz]

This is subclinical hyperthyroidism and typically does need to be
treated.   I personally have this...often seen with multinodular
goiters.  I recently saw a thyroid expert in NYC who placed me on
methimazole.  Often this can be treated with radioactive iodine, or
lifetime methimazole which is not always practical.  I need to have a
total thyroidectomy because the nodules are growing.(Biopsy negative)
There was a French study in the Lancet not too long ago (I am sorry I do
not have the specifics right now) but it discussed the need to treat
subclinical hyperthyroidism as there is an increased risk of atrial
fibrillation.  

I have spoken to several endo's about this exact type of finding and
there is some controversy as to how to treat.  I would send your patient
to an endo so they can treat her according to the ACCE guidelines. (The
expert endo association)

Pat Munz NP,CDE



-----Original Message-----
From: np-clinical-bounces at nurse.net
[mailto:np-clinical-bounces at nurse.net] On Behalf Of Sue Wiers
Sent: Friday, May 11, 2007 9:12 AM
To: np-clinical at nurse.net
Subject: [NP-Clinical] endocrine question

We have a patient who has a chronically suppressed TSH of 0.01 to 0.03
for 
several years.  However, all of her other thryoid values have been
perfectly 
normal (not even borderline).  Does anyone have an explanation for this?

Sue Wiers FNP

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