Subclinical hypothyroidism

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In medicine, subclinical hypothyroidism is an elevated thyrotropin (TSH) concentration can maintain a normal or near normal thyroxine (T4) concentration.[1][2][3]

Prognosis

Thyrotropin level

Evolution of thyrotropin values over 5 years.[4]
  Follow-up TSH value
TSH > 10 TSH < 10
TSH > 10 35% 64%
TSH 5.5 - 10 3% 97%

The thyrotropin level helps predict progression to overt hypothyroidism.[4]

Antithyroid peroxidase antibodies

Antithyroid peroxidase (also called antithyroid microsomal) antibodies my help predict progression to overt hypothyroidism.[5]

Screening

The US Preventive Services Task Force states:[1]

"t is uncertain whether treatment will improve quality of life in otherwise healthy patients who have abnormal TSH levels and normal free thyroxine levels"

References

  1. 1.0 1.1 Helfand M, U.S. Preventive Services Task Force (2004). "Screening for subclinical thyroid dysfunction in nonpregnant adults: a summary of the evidence for the U.S. Preventive Services Task Force.". Ann Intern Med 140 (2): 128-41. PMID 14734337[e]
  2. Surks MI, Ortiz E, Daniels GH, Sawin CT, Col NF, Cobin RH et al. (2004). "Subclinical thyroid disease: scientific review and guidelines for diagnosis and management.". JAMA 291 (2): 228-38. DOI:10.1001/jama.291.2.228. PMID 14722150. Research Blogging.
  3. Cooper DS, Biondi B (2012). "Subclinical thyroid disease.". Lancet 379 (9821): 1142-54. DOI:10.1016/S0140-6736(11)60276-6. PMID 22273398. Research Blogging.
  4. 4.0 4.1 Meyerovitch J, Rotman-Pikielny P, Sherf M, Battat E, Levy Y, Surks MI (2007). "Serum thyrotropin measurements in the community: five-year follow-up in a large network of primary care physicians.". Arch Intern Med 167 (14): 1533-8. DOI:10.1001/archinte.167.14.1533. PMID 17646608. Research Blogging. Cite error: Invalid <ref> tag; name "pmid17646608" defined multiple times with different content
  5. Díez JJ, Iglesias P (2004). "Spontaneous subclinical hypothyroidism in patients older than 55 years: an analysis of natural course and risk factors for the development of overt thyroid failure.". J Clin Endocrinol Metab 89 (10): 4890-7. DOI:10.1210/jc.2003-032061. PMID 15472181. Research Blogging.