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Presents a discussion on the diagnosis of goiter. Assessment of the thyroid gland size; Anatomic basis of thyroid examination; Examination of the gland for size; False-positive and false-negative goiters; Precision of estimating thyroid size; Accuracy of estimating thyroid size; Bias in estimating thyroid size.

Suggests an approach to clinicians on the laboratory diagnosis of principal thyroid disorders. Cause and treatment of hypothyroidism; Details of hypothyroidism and hyperthyroidism in pregnancy; Effect of drugs on thyroid hormone measurements; Information on a set of guidelines for diagnosis of hypothyroidism published by the American Thyroid Association.

This JAMA Guidelines Synopsis summarizes the 2017 American Thyroid Association guidelines on diagnosis and management of thyroid disease during pregnancy and the postpartum period. [ABSTRACT FROM AUTHOR]

The overall prevalence of thyroid hormone use in an unselected population of older adults (n = 2575; average age, 68.6 years) was 6.9% (10.0% in women and 2.3% in men). Eighty-one percent of women taking it were doing so for appropriate indications, eg, hypothyroidism, while 12% were not, eg, for obesity or high serum cholesterol; more men (29%) were taking it inappropriately. Inappropriate use was associated with desiccated thyroid more than with thyroxine. After follow-up averaging 6.9 years, 58% of inappropriate users were still taking it. Underuse also occurred. Thirty-seven percent of those definitely hypothyroid had a clearly elevated serum thyrotropin level (greater than 10 mU/L) despite thyroid therapy. Thyroid therapy is common in the elderly; most is appropriate. When inappropriate use occurs, it is more common in men and more often associated with desiccated thyroid, still commonly used in this age group. In chronic users of thyroid hormone, it is important to review currently appropriate indications and to measure serum thyrotropin levels to assess the adequacy of treatment of primary hypothyroidism. [ABSTRACT FROM AUTHOR]

The author offers insights on the criteria required by the institution of universal screening of pregnant women for overt thyroid disease, according to the World Health Organization. He discusses the prevalence of overt and subclinical thyroid disease during pregnancy, guidelines from the American Thyroid Association and Endocrine Society on thyroid disorders during pregnancy, and studies on the link between subclinical hypothyroidism and adverse pregnancy outcomes.