Dr. Victor Adlin

E. Victor Adlin, FACP, an endocrinologist at Temple University School of Medicine, discusses how the rosiglitazone drama has affected internists' prescribing habits

The hormone's effect is long-term because it affects cells, said endocrinologist Victor Adlin, an associate professor emeritus at Temple University School of Medicine.A big spike in strength "is not something that is going to happen immediately," Adlin said.

VICTOR ADLIN , M.D. ,Temple University School of Medicine , Philadelphia , Pennsylvania

While screening patients for thyroid disease , physicians often find increased thyrotropin-stimulating hormone ( TSH ) levels in patients whose free thyroxine ( T4 ) levels are not below normal.This state , termed subclinical hypothyroidism , is most commonly an early stage of hypothyroidism.Although the condition may resolve or remain unchanged , within a few years in some patients , overt hypothyroidism develops , with low free T4 levels as well as a raised TSH level.The likelihood that this will happen increases with greater TSH elevations and detectable antithyroid antibodies.Because patients with subclinical hypothyroidism sometimes have subtle hypothyroid symptoms and may have mild abnormalities of serum lipoproteins and cardiac function , patients with definite and persistent TSH elevation should be considered for thyroid treatment.Levothyroxine , in a dosage that maintains serum TSH levels within the normal range , is the preferred therapy in these patients.
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VICTOR ADLIN , M.D. , is associate professor emeritus in the section of endocrinology and metabolism , Department of Medicine , Temple University School of Medicine , Philadelphia.He is also an associate editor of the Annals of Internal Medicine.Dr. Adlin graduated from Temple University School of Medicine and completed a fellowship in endocrinology at Temple University Hospital.

Address correspondence to Victor Adlin , M.D. , 3401 N. Broad St. , Philadelphia , PA 19140.Reprints are not available from the author.

REFERENCES

Sawin CT , Chopra D , Azizi F , Mannix JE , Bacharach P. The aging thyroid.Increased prevalence of elevated serum thyrotropin levels in the elderly.

VICTOR ADLIN, M.D., Temple University School of Medicine, Philadelphia, Pennsylvania

While screening patients for thyroid disease, physicians often find increased thyrotropin-stimulating hormone (TSH) levels in patients whose free thyroxine (T4) levels are not below normal.This state, termed "subclinical hypothyroidism," is most commonly an early stage of hypothyroidism.Although the condition may resolve or remain unchanged, within a few years in some patients, overt hypothyroidism develops, with low free T4 levels as well as a raised TSH level.The likelihood that this will happen increases with greater TSH elevations and detectable antithyroid antibodies.Because patients with subclinical hypothyroidism sometimes have subtle hypothyroid symptoms and may have mild abnormalities of serum lipoproteins and cardiac function, patients with definite and persistent TSH elevation should be considered for thyroid treatment.Levothyroxine, in a dosage that maintains serum TSH levels within the normal range, is the preferred therapy in these patients.
...
VICTOR ADLIN, M.D., is associate professor emeritus in the section of endocrinology and metabolism, Department of Medicine, Temple University School of Medicine, Philadelphia.He is also an associate editor of the Annals of Internal Medicine.Dr. Adlin graduated from Temple University School of Medicine and completed a fellowship in endocrinology at Temple University Hospital.

Address correspondence to Victor Adlin, M.D., 3401 N. Broad St., Philadelphia, PA 19140.Reprints are not available from the author.

REFERENCES

Sawin CT, Chopra D, Azizi F, Mannix JE, Bacharach P. The aging thyroid.Increased prevalence of elevated serum thyrotropin levels in the elderly.