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CPE-001 · synthetic case FX-014
Amiodarone-associated overt biochemical pattern
On amiodarone: TSH 11.2 and FT4 0.6.
Purpose: Detect functional pattern and show medication etiology modifier.
Inputs the engine received
Patient
- Age and sex
- 60, male
Medications
- Amiodarone
- Yes
Symptoms
- Fatigue
- Present
- Weight gain
- Present
Laboratory
- TSH
- 11.2 mIU/L (ref 0.4–4.5)
- FT4
- 0.6 ng/dL (ref 0.8–1.8)
- ANTI-TPO
- 10 IU/mL (ref 0–35)
What the engine reports
Caution
A medication or exposure relevant to thyroid interpretation is documented. Review its possible contribution before assigning a final etiology or management pathway.
Detected clinical pattern
Biochemical Pattern Compatible with Overt Primary Hypothyroidism
Elevated TSH with FT4 below the laboratory reference range supports this pattern.
- Etiology / context: Medication/Exposure Modifier Present
Why this pattern was identified
- Elevated TSH with low FT4. TSH 11.2 mIU/L (ref 0.4–4.5) and FT4 0.6 ng/dL (ref 0.8–1.8).
- Medication/exposure documented. Amiodarone
Context modules routed
CTX-HT-DRUG Medication / Exposure Modifier
Flag possible drug- or exposure-associated thyroid dysfunction; do not automatically assign autoimmune etiology; consider specialist review for complex medication-related patterns.
Recommended next steps
For physician consideration. Urgent review always comes first.
- 1Confirm clinical context, etiology modifiers and medication/exposure history.
- 2Consider lipid panel, CBC and CK if clinically indicated.
- 3Physician to determine levothyroxine initiation and dose using age and cardiovascular context.
Evidence and rule trace · 2 rules
PR-HT-01Overt Primary Hypothyroidism Biochemical Pattern
Inputs: TSH 11.2 mIU/L (ref 0.4–4.5) · FT4 0.6 ng/dL (ref 0.8–1.8)
TSH above and FT4 below the laboratory reference range.
CTX-HT-DRUGMedication / Exposure Modifier
Context module routed.
Evidence
- EV-AACE-ATA-2012 · Garber JR et al. Clinical Practice Guidelines for Hypothyroidism in Adults. Endocr Pract. 2012;18(6):988-1028.
- EV-ATA-HYPO-2014 · Jonklaas J et al. Guidelines for the Treatment of Hypothyroidism. Thyroid. 2014;24(12):1670-1751.
Physician adjudication required. For clinician review only. This output identifies clinical patterns and safety considerations from the documented inputs. It does not establish an autonomous diagnosis or treatment plan. Physician confirmation is required.
Change the values
The same engine, starting from this case. Change any value and watch the pattern and the rule trace react.
Thyroid-function testsMove the sliders or type values
- below range
- within range
- above range
- below range
- within range
- above range
Zones are drawn from your reference intervals. The engine, not the map, decides the pattern.
Laboratory values and reference rangesUse your lab's own interval
µIU/mL and mIU/L are numerically identical.
Interpreted against the reporting assay's upper limit.
Only used in the thyrotoxicosis pathway.
Patient context
Medications and exposures
Symptoms and physical findingsSupportive only: never classify on their own
Symptoms
Signs and decompensation red flags
More thyroid cases
FX-001
Overt primary hypothyroidism with autoimmune support
A 54-year-old with fatigue, cold intolerance and a TSH of 18.4.
FX-002
Antibody positive with euthyroid function
Strongly positive antibodies, but TSH and FT4 are both normal.
FX-003
Mild subclinical pattern with positive Anti-TPO
Mildly high TSH, normal FT4, positive Anti-TPO.
FX-004
TSH at or above 10 with normal FT4
TSH of 12 with a normal FT4 in a woman of 57.
FX-005
Pregnancy context with mild TSH elevation and Anti-TPO positivity
Pregnant, TSH 3.1 against a pregnancy range, Anti-TPO positive.
FX-006
Preconception infertility context
Trying to conceive, TSH 4.8, Anti-TPO positive.
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