Hypothyroidism

Hypothyroidism — referral criteria for Endocrinology services.

Full SRC reference

Eligibility

At least one must be met for the patient to be eligible for referral.

Clinically suspected or confirmed hypothyroidism with initial primary-care work-up completed

Red flags

Indicate urgent (Category 1) referral or emergency assessment.

Suspected myxoedema coma (impaired conscious state, hypothermia, bradycardia) with high thyroid stimulating hormone level

Routine referral criteria

Determine Category 2 or 3 urgency.

Persistent hypothyroidism despite adequate replacement treatment

Pregnant women with thyroid stimulating hormone level (TSH) greater than 10 milliunit per litre with a history of Graves' disease or treatment with radioactive iodine

Suspected or confirmed secondary hypothyroidism (i.e. low thyroid stimulating hormone level (TSH) and low free thyroxine (T4))

Persistent thyroiditis that has lasted for more than 6 months

Usually managed in primary care

Clinically stable hypothyroidism
Primary hypothyroidism (except in patients with cardiac disease, pregnancy or if thyroxine treatment is contraindicated) that has not been treated with replacement therapy