SEMDSA/ACE-SA Guideline for the Management of Hypothyroidism in Adults

Joel A. Dave, Ania Klisiewicz, Zaheer Bayat, Nazeer Ahmed Mohamed, Zane Stevens, Tanya Kinvig
South African Family Practice | Vol 57, No 6 : November/December| a4399 | DOI: | ©
Submitted: 23 November 2015 | Published: 01 November 2015

About the author(s)

Joel A. Dave, Division of Diabetic Medicine and Endocrinology, Department of Medicine, University of Cape Town, South Africa
Ania Klisiewicz, Private Practice, Johannesburg, South Africa
Zaheer Bayat, Division of Endocrinology, Department of Medicine, University of the Witwatersrand, South Africa
Nazeer Ahmed Mohamed, Division of Endocrinology, Department of Medicine, University of the Witwatersrand, South Africa
Zane Stevens, Emeritus Professor of Medicine, Manager of the Christo Strydom Metabolic Research Unit, University of the Free State, South Africa
Tanya Kinvig, Private Practice, Cape Town, South Africa

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Background: Hypothyroidism is a common clinical condition confronting all healthcare practitioners yet there remains uncertainty about the optimal medication and optimum treatment targets. In addition, many patients remain symptomatic despite using recommended medications and attaining recommended treatment targets.

Methods: All endocrinologists in South Africa who consented to be part of the guideline process were assigned various aspects of the management of patients with thyroid disease. In each section the current literature was reviewed and the level of evidence was graded. This information was then presented at a guideline meeting. Where evidence was lacking a consensus among participants was adopted.

Results: This guideline provides 11 recommendations for the management of primary hypothyroidism, secondary hypothyroidism and subclinical hypothyroidism in adults.

Conclusions: This is the first South African guideline for the management of hypothyroidism in adults and represents a comprehensive review of the current literature in an attempt to provide evidence-based guidance for all healthcare practitioners regarding the many clinical aspects encountered when managing patients with hypothyroidism


hypothyroidism; adults; management; guidelines


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