Evidenced-based guidelines have been developed by several professional associations to address the diagnosis and management of thyroid diseases, including thyroid nodules, hypothyroidism, and hyperthyroidism. The recommendations from these guidelines discussed in this activity, address current controversies and challenges in thyroid disease management and common dilemmas faced by the primary care provider. Clinical issues in thyroid nodule management include the use of ultrasound, appropriate nodules for fine needle aspiration, indeterminate thyroid cytology, nodules in multinodular goiters, and approach to the incidentally discovered thyroid nodule. Controversies in the treatment of hypothyroidism include, approach to initiation and monitoring therapy, TSH targets, use of T4/T3 combinations and thyroid extracts, use of branded vs. generic levothyroxine products, and treatment in special populations, such as the elderly and pregnant women. Challenges in the management of hyperthyroidism include, selecting the appropriate therapy for the thyrotoxic patient, initiating and monitoring antithyroid drug treatment, duration of antithyroid drug treatment, treatment of subclinical hyperthyroidism, and management of drug-associated thyrotoxicosis, especially that associated with the use of amiodarone. Clinical cases will be used to illustrate the application of clinical practice guidelines.

Learning Objectives

•Utilize clinical practice guidelines to diagnose and manage thyroid nodules

•Utilize clinical practice guidelines to diagnose and manage hypothyroidism

Faculty Disclosures

The following financial relationships have been disclosed by faculty.

Gregory A. Brent, MD

Has no financial relationships to disclose.


Non-faculty contributors and others involved in the planning, development, and editing/review of the content have no relevant financial relationships to disclose.

Commercial Supporters

Not Applicable

Education Partners

Not Applicable


Not Applicable

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