Hypothyroidism iatrogenic

The vast majority of hypothyroid patients have thyroid gland failure (primary hypothyroidism). The causes include chronic autoimmune thyroiditis (Hashimoto s disease), iatrogenic hypothyroidism, iodine deficiency, enzyme defects, thyroid hypoplasia, and goitrogens. 

Melvin GR, Aceto T Jr, Barlow J, Munson D, Wierda D. Iatrogenic congenital goiter and hypothyroidism with respiratory distress in a newborn. S D J Med 1978 31(10) 15-19. 

The optimal dosage of levothyroxine should be based on repeated measurements of T3 and TSH serum concentrations. The daily recommended dose depends on the aim of the therapy. Thyroid replacement therapy for control of spontaneous or iatrogenic hypothyroidism should aim at a dosage of levothyroxine that maintains TSH concentrations within the low reference range. This will usually be associated with a free T4 concentration in the high reference range and a T3 concentration within the reference range. The mean requirement for such patients is... 

Iatrogenic hypothyroidism follows exposure to radiation (radioiodine or external radiation) or surgery. Hypothyroidism occurs within 3 months to a year after I therapy in most patients treated for Graves ... 

Autoimmunity (a) isolated autoimmune premature ovarian failure or (b) as a component of an autoimmune polyglandular syndrome in association with Addison s disease, hypothyroidism, hypoparathyroidism, or mucocutaneous candidiasis Iatrogenic (chemotherapy, radiation, extensive ovarian surgery) X-chromosome abnormalities... 

Insufficient control of hypothyroidism and excess dosage of T4 (iatrogenic thyrotoxicosis) are common in clinical practice. 

Jonckheer M.H. 1980. Iatrogenic hypothyrodism. In Bastenie P.A., Bonnijns M., Vanhaelst L. (Eds). Recent progress in diagnosis and treatment of hypothyroid conditions. Excerpta Medica, Congress Series Nr 529, Amsterdam, Ned. 15-28. 

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