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CPE-001 · Functional-state patterns
PR-HT-01: Overt Primary Hypothyroidism Biochemical Pattern
Overt Primary Hypothyroidism Biochemical Pattern. Definite biochemical pattern. Requires TSH above laboratory upper reference limit.
Required to fire
- TSH > laboratory upper reference limit
- FT4 < laboratory lower reference limit
Supportive, not required
- Compatible symptoms
- Anti TPO positive
- Dyslipidemia
- CK elevation
What it reports
- Functional state: overt primary hypothyroidism pattern
Recommended next steps (for physician review)
- Confirm clinical context, etiology modifiers and medication/exposure history.
- Assess Anti_TPO if autoimmune etiology is clinically relevant and not previously known.
- Consider lipid panel, CBC and CK if clinically indicated.
- Physician to determine levothyroxine initiation and dose using age and cardiovascular context.
Evidence
- EV-AACE-ATA-2012Garber JR et al. Clinical Practice Guidelines for Hypothyroidism in Adults. Endocr Pract. 2012;18(6):988-1028.Supports: Subclinical hypothyroidism below TSH 10 requires individualized treatment decision.
- EV-ATA-HYPO-2014Jonklaas J et al. Guidelines for the Treatment of Hypothyroidism. Thyroid. 2014;24(12):1670-1751.Supports: Levothyroxine management framework for hypothyroidism.
Cases where this rule fires
Open a case to see this rule fire with real inputs, then change the values until it stops.
FX-001
Overt primary hypothyroidism with autoimmune support
A 54-year-old with fatigue, cold intolerance and a TSH of 18.4.
FX-010
Postpartum overt hypothyroid pattern with iron deficiency context
Eight months postpartum, TSH 12.4, low FT4, mild anemia.
FX-013
Severe decompensation risk alert
A 78-year-old, confused and cold, with TSH 38.5 and sodium 128.
FX-014
Amiodarone-associated overt biochemical pattern
On amiodarone: TSH 11.2 and FT4 0.6.
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