CSEM Review and Response: Thyroid Testing and Management

CSEM and Choosing Wisely Canada have recently received feedback from patients regarding CSEM’s recommendation #3, Don’t use Free T4 or T3 to screen for hypothyroidism or to monitor and adjust levothyroxine (T4) dose in patients with known primary hypothyroidism.

In response to patient concerns regarding the recommendation, CSEM and Choosing Wisely Canada requested an independent review of the medical literature from the Canadian Agency for Drugs and Technologies in Health.

Following this independent review, CSEM has modified recommendation #3 to clarify that patients should have access to additional testing, as required.

CSEM is committed to:

  • Updating its members on the review and response to patient concerns, and on the modified Choosing Wisely recommendation.
  • Reviewing the full list of recommendations on an annual basis. Choosing Wisely Canada recommendations are reviewed yearly and updated with current evidence.
  • Collecting patient experiences regarding hypothyroidism testing and management, as well as other thyroid issues, and particularly, funding and coverage issues.
  • CSEM is working with the Thyroid Foundation of Canada to advocate for appropriate care for thyroid patients.
  • Fostering opportunities for new research that may help guide these important testing and treatment decisions for patients with thyroid disease.