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REVIEW ARTICLE
Year : 2020  |  Volume : 17  |  Issue : 2  |  Page : 53-55

A 6 Dimensional approach to diagnosing refractory hypothyroidism


1 Bharti Research Institute of Diabetes and Endocrinology, Karnal, Haryana, India
2 Department of Endocrinology, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India

Correspondence Address:
Dr. Prem Narayanan
Department of Endocrinology, Amrita Institute of Medical Sciences and Research Centre, Ponekkara P. O, Kochi - 682 041, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/trp.trp_14_20

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Refractory hypothyroidism is a commonly encountered clinical challenge despite hypothyroidism being an easy condition to manage. However, truly refractory hypothyroidism accounts for only a small proportion of refractory hypothyroidism, remainder being “pseudo-refractory.” The 6-dimensional tool helps guide physicians to manage poorly controlled hypothyroid individuals better. This tool highlights some important aspects of evaluating such individuals such as dialogue, diagnosis, definition of endpoint, disturbance in assay, drug intake (L-thyroxine and concomitant drug intake), and comorbid disease. Most importantly, this simple reader friendly tool can help differentiate truly refractory from pseudo-refractory hypothyroidism. The latter being easily correctable holds the promise of improving the quality of life in such individuals.


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