Monday, November 18, 2019
A new guideline from the Canadian Task Force on Preventive Health Care recommends against routine screening for thyroid dysfunction in nonpregnant adults without symptoms or risk factors. This guideline is published in the Canadian Medical Association Journal.
Routine testing for thyroid dysfunction is commonly ordered, by checking the "thyroid stimulating hormone (TSH)" box on a blood test requisition form, although practice varies by primary care practitioner. An abnormal TSH level may indicate an underactive (hypothyroidism) or overactive thyroid gland (hyperthyroidism).
The task force looked at 22 studies on the effectiveness of treatment for abnormal TSH findings in asymptomatic adults and found no evidence of benefits from screening and treatment in people without symptoms. Harms of unnecessary testing include the need to take medication unnecessarily and have regular medical visits and follow-up blood tests to check TSH levels.
"If you are a clinician who orders TSH tests as part of preventive health visits, we would like you to reconsider this practice. The evidence isn't there to suggest a health benefit for this type of screening as a routine part of care.”
- Dr. Richard Birtwhistle, Emeritus professor of Family Medicine and Public Health Sciences at Queen's University and Chair of the Task Force Thyroid Dysfunction working group.
“The recommendations do not apply to people with symptoms that may indicate an over- or under-active thyroid gland, or who have risk factors for thyroid disease, such as previous head or neck radiation, exposure to certain medications, and pituitary or hypothalamic diseases."
- Dr. Donna Reynolds, task force working group member
Links
The research appeared in the Canadian Medical Association Journal.
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