EPISODE · Mar 4, 2021 · 58 MIN
TdC 78: Hipotireoidismo feat Dra Nathalie Santana
from Ta de Clinicagem · host tadeclinicagem
🚨 www.tadeclinicagem.com.br/guia - Conheça o Guia TdC com 7 dias grátis 🚨Rapha e João batem um papo sobre Hipotireoidismo com a Dra Nathalie Santana, clínica pela UNIFESP/EPM, endocrinologista pela HCFMUSP e professora da UNIT (Universidade Tiradentes) e UFS (Universidade Federal do Sergipe). Leia também o tópico do Guia TdC: https://www.tadeclinicagem.com.br/guia/358/hipotireoidismo-subclinico/Minutagem(1:40) Apresentação da convidada Dra. Nathalie Santana(2:50) Ressalva do episódio dio(3:30) Exames do hipotireoidismo - anti TPO e anti- tireoglobulina(5:50) Drogas e hipotireoidismo(8:00) Quadro clínico(9:13) Obesidade e tireoide(10:55) anemia, hiponatremia, miopatia e sd de aprisionamento de nervo(15:08) Quais exames solicitar?(18:53) Sd do eutiroideu doente(20:00) Biotina nos exames laboratoriais(21:24) O que não precisa pedir(22:00) Tratamento(23:43) Dose inicial(26:54) Cuidados nos idosos(28:45) Relação levotiroxina e peso(30:26) Orientações sobre levotiroxina(32:38) Fatores que alteram a absorção(34:25) Situações maleáveis(36:26) Levotiroxina e estrogênio(37:20) Último caso(40:40) Ajuste de dose(42:24) Metas do TSH(44:08) Resumo do tratamento + clinicagens(47:40) Hipotireoidismo subclinico(48:35) Quando tratar(48:58) Quando não tratar(51:11) Porque tratar os jovens(52:20) Outros casos(53:20) Como tratar o hipotireoidismo subclínico(55:55) Salves(56:30) Desafio da semana anterior(57:36) Desafio da semanaReferências: 1- Uptodate 2021. Treatment of primary hypothyroidism in adults. Douglas S Ross., David S Cooper, Jean E Mulder MD. 2- SANTINI, Ferruccio et al. Lean body mass is a major determinant of levothyroxine dosage in the treatment of thyroid diseases. The Journal of Clinical Endocrinology & Metabolism, v. 90, n. 1, p. 124-127, 2005. 3- SKELIN, Marko et al. Effect of timing of levothyroxine administration on the treatment of hypothyroidism: a three-period crossover randomized study. Endocrine, v. 62, n. 2, p. 432-439, 2018. 4- BERNSTEIN, Robert S.; ROBBINS, Jacob. Intermittent therapy with L-thyroxine. New England Journal of Medicine, v. 281, n. 26, p. 1444-1448, 1969. 5- JONKLAAS, Jacqueline et al. Evidence-Based Use of Levothyroxine/Liothyronine Combinations in Treating Hypothyroidism: A Consensus Document. European Thyroid Journal, v. 10, n. 1, p. 10-38, 2021. 6- WILDISEN, Lea et al. Effect of Levothyroxine Therapy on the Development of Depressive Symptoms in Older Adults With Subclinical Hypothyroidism: An Ancillary Study of a Randomized Clinical Trial. JAMA network open, v. 4, n. 2, p. e2036645-e2036645, 2021. 7- STOTT, David J. et al. Thyroid hormone therapy for older adults with subclinical hypothyroidism. New England Journal of Medicine, v. 376, n. 26, p. 2534-2544, 2017. 8- MOOIJAART, Simon P. et al. Association between levothyroxine treatment and thyroid-related symptoms among adults aged 80 years and older with subclinical hypothyroidism. Jama, v. 322, n. 20, p. 1977-1986, 2019. 9- BEKKERING, G. E. et al. Thyroid hormones treatment for subclinical hypothyroidism: a clinical practice guideline. Bmj, v. 365, 2019. 10- Society for Endocrinology & British Thyroid Association issue statement against new treatment recommendations for subclinical hypothyroidism 11- BIONDI, Bernadette; CAPPOLA, Anne R.; COOPER, David S. Subclinical hypothyroidism: a review. Jama, v. 322, n. 2, p. 153-160, 2019. 12- JONKLAAS, Jacqueline et al. Guidelines for the treatment of hypothyroidism: prepared by the american thyroid association task force on thyroid hormone replacement. thyroid, v. 24, n. 12, p. 1670-1751, 2014.
What this episode covers
Rapha e João batem um papo sobre Hipotireoidismo com a Dra Nathalie Santana, clínica pela UNIFESP/EPM, endocrinologista pela HCFMUSP e professora da UNIT (Universidade Tiradentes) e UFS (Universidade Federal do Sergipe). Minutagem (1:40) Apresentação da convidada Dra. Nathalie Santana (2:50) Ressalva do episódio dio (3:30) Exames do hipotireoidismo - anti TPO e anti- tireoglobulina (5:50) Drogas e hipotireoidismo (8:00) Quadro clínico (9:13) Obesidade e tireoide (10:55) anemia, hiponatremia, miopatia e sd de aprisionamento de nervo (15:08) Quais exames solicitar? (18:53) Sd do eutiroideu doente (20:00) Biotina nos exames laboratoriais (21:24) O que não precisa pedir (22:00) Tratamento (23:43) Dose inicial (26:54) Cuidados nos idosos (28:45) Relação levotiroxina e peso (30:26) Orientações sobre levotiroxina (32:38) Fatores que alteram a absorção (34:25) Situações maleáveis (36:26) Levotiroxina e estrogênio (37:20) Último caso (40:40) Ajuste de dose (42:24) Metas do TSH (44:08) Resumo do tratamento + clinicagens (47:40) Hipotireoidismo subclinico (48:35) Quando tratar (48:58) Quando não tratar (51:11) Porque tratar os jovens (52:20) Outros casos (53:20) Como tratar o hipotireoidismo subclínico (55:55) Salves (56:30) Desafio da semana anterior (57:36) Desafio da semana Referências: 1- Uptodate 2021. Treatment of primary hypothyroidism in adults. Douglas S Ross., David S Cooper, Jean E Mulder MD. 2- SANTINI, Ferruccio et al. Lean body mass is a major determinant of levothyroxine dosage in the treatment of thyroid diseases. The Journal of Clinical Endocrinology & Metabolism, v. 90, n. 1, p. 124-127, 2005. 3- SKELIN, Marko et al. Effect of timing of levothyroxine administration on the treatment of hypothyroidism: a three-period crossover randomized study. Endocrine, v. 62, n. 2, p. 432-439, 2018. 4- BERNSTEIN, Robert S.; ROBBINS, Jacob. Intermittent therapy with L-thyroxine. New England Journal of Medicine, v. 281, n. 26, p. 1444-1448, 1969. 5- JONKLAAS, Jacqueline et al. Evidence-Based Use of Levothyroxine/Liothyronine Combinations in Treating Hypothyroidism: A Consensus Document. European Thyroid Journal, v. 10, n. 1, p. 10-38, 2021. 6- WILDISEN, Lea et al. Effect of Levothyroxine Therapy on the Development of Depressive Symptoms in Older Adults With Subclinical Hypothyroidism: An Ancillary Study of a Randomized Clinical Trial. JAMA network open, v. 4, n. 2, p. e2036645-e2036645, 2021. 7- STOTT, David J. et al. Thyroid hormone therapy for older adults with subclinical hypothyroidism. New England Journal of Medicine, v. 376, n. 26, p. 2534-2544, 2017. 8- MOOIJAART, Simon P. et al. Association between levothyroxine treatment and thyroid-related symptoms among adults aged 80 years and older with subclinical hypothyroidism. Jama, v. 322, n. 20, p. 1977-1986, 2019. 9- BEKKERING, G. E. et al. Thyroid hormones treatment for subclinical hypothyroidism: a clinical practice guideline. Bmj, v. 365, 2019. 10- Society for Endocrinology & British Thyroid Association issue statement against new treatment recommendations for subclinical hypothyroidism 11- BIONDI, Bernadette; CAPPOLA, Anne R.; COOPER, David S. Subclinical hypothyroidism: a review. Jama, v. 322, n. 2, p. 153-160, 2019. 12- JONKLAAS, Jacqueline et al. Guidelines for the treatment of hypothyroidism: prepared by the american thyroid association task force on thyroid hormone replacement. thyroid, v. 24, n. 12, p. 1670-1751, 2014.
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TdC 78: Hipotireoidismo feat Dra Nathalie Santana
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