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CPE-008 · Safety
AI-15: Central hypothyroidism: assess the adrenal axis first
Central hypothyroidism: assess the adrenal axis first. Evaluates low free T4 with low or normal TSH (central pattern).
Condition
- low free T4 with low or normal TSH (central pattern)
What it reports
- Assess adrenal function before thyroid hormone replacement: levothyroxine can precipitate adrenal crisis in unrecognized insufficiency
Diagnostic boundary
- Links to the thyroid engine.
Evidence
- EV-ES-HYPOPIT-2016Fleseriu M, Hashim IA, Karavitaki N, et al. Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016;101(11):3888-3921.Supports: Assess the adrenal axis before thyroid replacement in central hypothyroidism Secondary adrenal insufficiency testing
Cases where this rule fires
Open a case to see this rule fire with real inputs, then change the values until it stops.
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