Referral criteria from primary care - thyroid disease
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:
- Thyroid disease: assessment and management. NICE guideline NG145. Published: 20 November 2019 Last updated: 12 October 2023.
- Vaidya B, Pearce SH. Diagnosis and management of thyrotoxicosis. BMJ. 2014 Aug 21;349:g5128
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