Rehman and Bajwa listed criteria for when to refer a patient with hypothyroidism to an endocrinologist. The authors are from Broomfield Hospital and Figges Marsh Surgery in England.
Indications for referral of a patient with hypothyroidism to an endocrinologist:
(1) onset in a woman who is pregnant or postpartum (possibility of Sheehan's syndrome or lymphocytic hypophysitis)
(2) evidence of pituitary disease (hypopituitarism)
(3) onset while being treated with lithium or amiodarone
(4) presence of ischemic heart disease
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