Some organizations (such as the United States Preventive Services Task Force) state that evidence is insufficient to support routine screening, while others (such as the American Thyroid Association) recommend either intermittent testing above a certain age in all sexes or only in women. Targeted screening may be appropriate in a number of situations where hypothyroidism is common: other autoimmune diseases, a strong family history of thyroid disease, those who have received radioiodine or other radiation therapy to the neck, those who have previously undergone thyroid surgery, those with an abnormal thyroid examination, those with psychiatric disorders, people taking amiodarone or lithium, and those with a number of health conditions (such as certain heart and skin conditions). Yearly thyroid function tests are recommended in people with Down syndrome, as they are at higher risk of thyroid disease. Guidelines for England and Wales from the National Institute for Health and Care Excellence (NICE) recommend testing for thyroid disease in people with type 1 diabetes and new-onset atrial fibrillation, and suggests testing in those with depression or unexplained anxiety (all ages), in children with abnormal growth, or unexplained change in behaviour or school performance. On diagnosis of autoimmune thyroid disease, NICE also recommends screening for celiac disease. Management
Hormone replacement
Most people with hypothyroidism symptoms and confirmed thyroxine deficiency are treated with a synthetic long-acting form of thyroxine, known as levothyroxine (L-thyroxine).
A "flare" is a spreading area of redness or flush. It is the second reaction in the triple response to injury and is due to dilatation of the arteriole. When this flare occurs around the ankle, it is called an ankle flare. The condition is also known as a malleolar flare, in reference to the malleolus, the bony prominence on each side of the ankle. Ankle flares are often caused by venous ulcer, due to deep vein thrombosis or varicose veins. It is considered to be an early sign of advanced venous disease. Treatment involves management of the underlying condition, along with supportive care. See also
Corona phlebectatica


== References ==