Letters to the editor

摘要

The updated clinical practice guidelines for hypo-thyroidism in adults, from the task force of the American Thyroid Association and the American Association of Clinical Endocrinologists (1), provide a comprehensive and useful review, but there are some real concerns.First, the clinical symptoms of hypothyroidism (dry skin, cold sensitivity, fatigue, and constipation) are marginalized, despite one reference to the increased neuropsychi-atric complaints of patients with Hashimoto's thyroiditis (irritability, nervousness, lower quality of life) (2). Clinical signs are ignored, other than the comment that early (3,4) and more recent studies (5) show a strong correlation between hypothyroidism and the delayed relaxation phase of the ankle reflexes.