Swinging From Hypothyroidism to Hyperthyroidism: A Rare Entity Yet With Different Pathophysiology (Case-Based Review)
Bibliographic record
Abstract
Although rare but some patients developed hyperthyroidism preceded by hypothyroidism after being treated with levothyroxine. I reported a 35-year-old male who developed hyperthyroidism after getting treated with levothyroxine for hypothyroidism. Patient showed evident clinical and biochemical hypothyroidism with TSH of 175 ? U/mL and free T4 of 2.7 pmol/L, and started on levothyroxine. Levothyroxine was stopped after 3 years as he had become euthyroid. However, over a period of 1 year, he gradually had developed thyrotoxic state with TSH less than 0.01 ? U/mL and T4 of 26 pmol/L and clinical symptoms of thyrotoxicosis. He has now started on methimazole 5 mg/day and will be followed up in 6 months. Therefore, physicians are required to have a frequent assessment of thyroid function test to identify the occurrence of this rare entity of swinging from hypothyroidism to hyperthyroidism in order to initiate proper treatment. J Endocrinol Metab. 2016;6(4):127-128 doi: http://dx.doi.org/10.14740/jem370w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".