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Simon H.S. Pearce Institute of Genetic Medicine, Newcastle University and Endocrine Unit, Royal Victoria Infirmary, Newcastle upon Tyne, UK;

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Mario Vaisman Department of Endocrinology, Faculdade de Medicina, UFRJ, Rio de Janeiro, Brazil;

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Jean-Louis Wemeau Clinique Endocrinologique Marc Linquette, CHU, Lille, France

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results of the participants’ opinion are shown in figure 1 . Fig. 1 Case scenario 1, 53-year-old female, TSH 6.8 mU/l. Case 1b: As in case 1a, but she was also now noted to have dyslipidaemia, with a serum LDL cholesterol of 6

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Simon H.S. Pearce Institute of Genetic Medicine, Newcastle University
Royal Victoria Infirmary, Newcastle upon Tyne, UK

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Georg Brabant Medizinische Klinik I, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany

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Leonidas H. Duntas Endocrine Unit, Evgenidion Hospital, University of Athens, Athens, Greece

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Fabio Monzani Department of Clinical and Experimental Medicine, Università di Pisa, Pisa, Italy

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Robin P. Peeters Rotterdam Thyroid Center, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands

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Salman Razvi Institute of Genetic Medicine, Newcastle University
Queen Elizabeth Hospital, Gateshead, UK

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Jean-Louis Wemeau Clinique Endocrinologique Marc Linquette, CHU, Lille, France

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through March 2013. For our Medline search, we entered in various combinations the terms thyrotropin (TSH), L -thyroxine, SCH, goitre, replacement therapy, CV risk, heart, dyslipidaemia, diabetes, obesity, mental health, quality of life, drugs. The

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Nancy Van Wilder Departments of Endocrinology, Vrije Universiteit Brussel, Brussels, Belgium

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Bert Bravenboer Departments of Endocrinology, Vrije Universiteit Brussel, Brussels, Belgium

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Sarah Herremans Departments of Psychiatry, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium

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Nathalie Vanderbruggen Departments of Psychiatry, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium

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Brigitte Velkeniers Departments of Endocrinology, Vrije Universiteit Brussel, Brussels, Belgium

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developed severe hypothyroidism (TSH 201 mIU/ml and fT 4 of 2.3 pmol/L) with symptoms of fatigue, increasing weight, constipation, hoarse voice and cold intolerance. She also had abnormal liver function tests and dyslipidaemia. In her personal medical

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K. Alexander Iwen Medizinische Klinik I, Experimentelle und Klinische Endokrinologie, Universität zu Lübeck, Lübeck, Germany

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Erich Schröder Medizinische Klinik I, Experimentelle und Klinische Endokrinologie, Universität zu Lübeck, Lübeck, Germany

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Georg Brabant Medizinische Klinik I, Experimentelle und Klinische Endokrinologie, Universität zu Lübeck, Lübeck, Germany
Department of Endocrinology, The Christie Manchester Academic Health Science Centre, Manchester, UK

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patients. This fits to previous studies were increased triglycerides were found in approximately 1/3 of all patients with overt hypothyroidism, mainly as part of dyslipidaemia type IIb but also of type IV. These relations are less clear in subclinical

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