Thyroid.

Introduction: Hypothyroidism is one of the most prevalent endocrine diseases. Though the treatment of hypothyroidism is straightforward, data from several studies show that only around 60% of patients on thyroxine replacement have normal thyroid stimulating hormone (TSH) levels. We, therefore, undertook an audit of hypothyroid patients attending a tertiary care center. Objectives: To determine the prevalence of various etiologies causing hypothyroidism. To ascertain the dose of thyroxine required to attain euthyroid status and its determinants. Materials and Methods: A retrospective audit of hypothyroid patients attending the thyroid clinic in Bai Yamunabai Laxman Nair Charitable Hospital, Mumbai (excluding patients with follow up of less than 3 months, pregnancy, thyroid carcinoma, known gastrointestinal (GI) disorders, and medical illness) has been undertaken. Hospital records and clinical evaluation are being used to collect data on various parameters like etiology, frequency of TSH monitoring, recent value of TSH, current weight, and dose of thyroxine. Results: Eighty-one (73 females) patient's interviews have been conducted in this ongoing study. Of these patients 69% have autoimmune hypothyroidism (AH), 17.28% have post operative hypothyroidism (POH), 8.64% have post radioactive iodine hypothyroidism (PRH) and 4.93% have congenital hypothyroidism (CH). Euthyroidism and iatrogenic hyperthyroidism were observed in 61.7% and 9.8% cases, respectively. Average dose requirement of thyroxine is 1.53 ±0.35 μg/kg in AH, 1.5 ± 0.41 μg/kg in POH, and 1.5 ± 1.34 μg/kg in PRH. Euthyroid status is better attained in POH (71.42%) as compared to AH (62.5%) and PRH group (57.14%). Conclusion: Autoimmune Hypothyroidism is the commonest etiology of hypothyroidism. Euthyroid status was achieved in 61.7% of overall patients. Adherence to therapy and attainment of euthyroid status is best in POH. Dose requirement is similar across all major etiologies of hypothyroidism. Periodic monitoring is essential to maintain and improve standard of patient care especially of chronic illnesses. [ABSTRACT FROM AUTHOR]