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Referral criteria from primary care - thyroid disease

Authoring team

Patients with hypothyroidism can expect to be referred if:

  • aged <16
  • pregnant or post partum
  • evidence of pituitary disease
  • newborn infant

Referral should also be considered if (2)

  • there are particular problems such as "active and unstable ischaemic heart disease (2)" or treatment with amiodarone or lithium
  • symptoms do not respond or worsen after treatment with levothyroxine
  • serum TSH level is persistently raised while on full dose of levothyroxine (2)

Patients with hyperthyroidism can reasonably expect to be referred for a specialist opinion at diagnosis.

References:

  1. Thyroid disease: assessment and management. NICE guideline NG145. Published: 20 November 2019 Last updated: 12 October 2023.
  2. Vaidya B, Pearce SH. Diagnosis and management of thyrotoxicosis. BMJ. 2014 Aug 21;349:g5128

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