To the Editor We thank Portillo-Sanchez and colleagues1 for presenting a case of new-onset atrial fibrillation in an elderly man associated with the initiation of levothyroxine therapy, which called clinician attention to the potential overdiagnosis and overtreatment for subclinical hypothyroidism in elderly patients. However, when interpreting the detrimental outcome in this patient, the improperly high starting dose of levothyroxine could be of responsibility. To be noted, this dosage was against the current practice guidelines.2,3
Li Q, Tian H, Li S. Promoting Compliance to Practice Guidelines May Improve Primary Care for Thyroid Diseases. JAMA Intern Med. 2017;177(6):894–895. doi:10.1001/jamainternmed.2017.1404
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