Samenvatting van de NHG-standaard ‘Schildklieraandoeningen’

The ‘Thyroid disorders’ guideline of the Dutch College of General Practitioners (NHG) provides recommendations for the diagnosis and management of hypothyroidism, hyperthyroidism and changes in the size of the thyroid gland, such as goitre and thyroid nodules.

Hypothyroid patients younger than 60 years and without cardiac comorbidity should receive the full substitution dose of levothyroxine at treatment onset.

In case of hypothyroidism in pregnancy, the levothyroxine dose should be immediately increased by 25%.

All pregnant patients with (a history of) thyroid diseases should be tested for TSH-receptor antibodies at the start of the pregnancy.

Management of subclinical hypo- and hyperthyroidism consists of monitoring laboratory values due to the great likelihood of normalization of the TSH value.

All patients with a solitary nodule or a dominant nodule in a multinodular goitre should be referred to an endocrinologist for further investigation.