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. 2012 Apr;1(1):45-50.
doi: 10.1159/000335964. Epub 2012 Feb 29.

Management of subclinical hypothyroidism: the thyroidologists' view

Simon H S Pearce  1 , Mario Vaisman  2 , Jean-Louis Wemeau  3
Affiliations

Management of subclinical hypothyroidism: the thyroidologists' view

Simon H S Pearce et al. Eur Thyroid J. 2012 Apr.

Abstract

Subclinical hypothyroidism is a common finding when serum thyrotropin and thyroid hormones are measured, but the benefits of treating such patients with levothyroxine remain unproven. During the 14th International Thyroid Congress, a debate and discussion relating to three different clinical case scenarios of subclinical hypothyroidism was held. The audience consisted predominantly of members of the European Thyroid Association. Participants (n = 380) voted using an electronic system to express their opinion about the treatment of the 3 cases. For a 53-year-old woman with fatigue and difficulty losing weight, who has a serum TSH of 6.8 mU/l, 49% would treat with levothyroxine. Whereas, for an 84-year-old woman with a serum TSH of 6.8 mU/l, only 8% of participants would treat with levothyroxine. In contrast, for a 39-year-old woman who is trying to become pregnant, with a serum TSH of 4.5 mU/l and strongly positive thyroid peroxidase antibodies, 95% of respondents would treat with levothyroxine. This article details the clinical case scenarios and the results of the thyroidologists' opinions on treatment. It forms a snapshot of the range of accepted clinical practice in this common condition.

Keywords: Dyslipidaemia; Hashimoto's thyroiditis; Subclinical hypothyroidism; Thyrotropin.

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Figures

Fig. 1
Fig. 1
Case scenario 1, 53-year-old female, TSH 6.8 mU/l.
Fig. 2
Fig. 2
Case scenario 2, 84-year-old female, TSH 6.8 mU/l.
Fig. 3
Fig. 3
Case scenario 3, 39-year-old female, TSH 4.5 mU/l.
Fig. 4
Fig. 4
In general, how do you manage subclinical hypothyroidism?
See this image and copyright information in PMC

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