New Page 16
In accordance with standard diagnostic and therapeutic procedures o patient with hypothyroidism screening for hypothyroidism may be performed by a general physician:
patients with a positive family history thyroid disease
in patients with no apparent body weight change causes,
in patients with bradycardia,
patients with prior radiation to head and neck.
If general physician in primary examination suspected thyroid dysfunction detects TSH elevation, indicates free thyroxine (fT4) and thyroid antibodies Peroxidase (aTPO).
A definitive diagnosis and differential diagnosis is performed endocrinologist or internist. The endocrinologist also conducts diagnostics and differential diagnosis of central hypothyroidism. Treatment of hypothyroidism is initiated a manage endocrinologist or internist in all patients until setup dose of levothyroxine.
Additional management is performed by a general physician in patients without
cardiac disease excluding pregnant women.
Pregnant women are managed by an endocrinologist. General doctor or intern may
if the patient has hypothyroidism, consult an endocrinologist if
does not respond adequately to substitution therapy unless the patient has another
autoimmune disease of the endocrine system, if it has nodosis or if it has
the development of a nodose string during patient follow-up.
Current wording of the standard diagnostic and therapeutic procedure
with hypothyroidism is published under Endocrinology:
https://www.standardprocedures.sk/standards-endocrinology/.