Vnitr Lek 2023, 69(6):394-396 | DOI: 10.36290/vnl.2023.077

Subclinical hypothyroidism

Jan Drugda, Jan Čáp, Filip Gabalec
IV. interní klinika Fakultní nemocnice Hradec Králové a Lékařská fakulta Univerzity Karlovy v Hradci Králové

Subclinical hypothyroidism is a relatively common condition characterized by elevated serum TSH levels, but normal free thyroxine levels. The risks associated with subclinical hypothyroidism are less severe compared to those with overt hypothyroidism, making it essential to carefully select patients who would benefit from the treatment. Factors such as the patient´s age, comorbidities, symptoms, and TSH concentration need to be considered in this selections proces. The therapy, if required, consists of levothyroxine substitution with carefull dose titration to avoid overtreatment. The goal is to normalize TSH levels. Untreated patients should be folowed up accordingly to their risk factors mainly the risk of progression to overt hypothyroidism. Aproach to each patient should be individulized and flexible.

Keywords: thyroid gland, hypothyroidism, subclinical hypothyroidism, TSH, levothyroxine.

Accepted: September 21, 2023; Published: October 10, 2023  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Drugda J, Čáp J, Gabalec F. Subclinical hypothyroidism. Vnitr Lek. 2023;69(6):394-396. doi: 10.36290/vnl.2023.077.
Download citation

References

  1. Canaris GJ, Manowitz NR, Mayor G, et al. The Colorado thyroid disease prevalence study. Arch Intern Med. 2000 Feb 28;160(4):526-34. Available from: DOI:. Go to original source... Go to PubMed...
  2. Vanderpump MP, Tunbridge WM, French JM, et al. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey. Clin Endocrinol (Oxf). 1995 Jul;43(1):55-68. Available from: DOI:http://doi.org/10.1111/j.1365-2265.1995.tb01894.x Go to original source... Go to PubMed...
  3. Surks MI, Hollowell JG. Age-specific distribution of serum thyrotropin and antithyroid antibodies in the US population: implications for the prevalence of subclinical hypothyroidism. J Clin Endocrinol Metab. 2007 Dec;92(12):4575-82. Available from: DOI:. Go to original source... Go to PubMed...
  4. Jorde R, Waterloo K, Storhaug H, et al. Neuropsychological function and symptoms in subjects with subclinical hypothyroidism and the effect of thyroxine treatment. J Clin Endocrinol Metab. 2006 Jan;91(1):145-53. doi: 10.1210/jc.2005-1775. Epub 2005 Nov 1. Dostupné z DOI:. Go to original source... Go to PubMed...
  5. Villar HC, Saconato H, Valente O, et al. Thyroid hormone replacement for subclinical hypothyroidism. Cochrane Database Syst Rev. 2007 Jul 18;2007(3):CD003419. Available from: DOI:. Go to original source... Go to PubMed...
  6. Meuwese CL, van Diepen M, Cappola AR, et al. Low thyroid function is not associated with an accelerated deterioration in renal function. Nephrol Dial Transplant. 2019;34:650-59. Available from: DOI:. Go to original source... Go to PubMed...
  7. Blum MR, Bauer DC, Collet TH, et al. Subclinical thyroid dysfunction and fracture risk: a meta-analysis. JAMA. 2015 May 26;313(20):2055-65. Dostupné z DOI:. Go to original source... Go to PubMed...
  8. Akintola AA, Jansen SW, van Bodegom D, et al. Subclinical hypothyroidism and cognitive function in people over 60 years: a systematic review and meta-analysis. Front Aging Neurosci. 2015;7:150. Dostupné z DOI:https://doi.org/10.3389/fnagi.2015.00150. Go to original source... Go to PubMed...
  9. Gencer B, Collet TH, Virgini V, et al. Subclinical thyroid dysfunction and the risk of heart failure events: an individual participant data analysis from 6 prospective cohorts. Circulation. 2012;126:1040-49. Dostupné z DOI:. Go to original source... Go to PubMed...
  10. Rodondi N, den Elzen WP, Bauer DC, et al. Subclinical hypothyroidism and the risk of coronary heart disease and mortality. JAMA 2010;304:1365-74. Dostupné z DOI:http://doi.org/10.1001/jama.2010.1361>. Go to original source... Go to PubMed...
  11. Chaker L, Baumgartner C, Ikram MA, et al. Subclinical thyroid dysfunction and the risk of stroke: a systematic review and metaanalysis. Eur J Epidemiol. 2014;29:791-800. Dostupné z DOI:http://doi.org/10.1007/s10654-014-9946-8. Go to original source... Go to PubMed...
  12. Boelaert K, Horacek J, Holder RL, et al. Serum Thyrotropin Concentration as a Novel Predictor of Malignancy in Thyroid Nodules Investigated by Fine-Needle Aspiration. J ClinEndocrinolMetab. 2006 Nov;91(11):4295-301. Dostupné z DOI:. Go to original source... Go to PubMed...
  13. Huber G, Staub JJ, Meier C, et al. Prospective study of the spontaneous course of subclinical hypothyroidism: prognostic value of thyrotropin, thyroid reserve, and thyroid antibodies. J Clin Endocrinol Metab. 2002;87:3221-3226. Dostupné z DOI:. Go to original source... Go to PubMed...
  14. Pearce SH, Brabant G, Duntas LH, et al. 2013 ETA Guideline: Management of Subclinical Hypothyroidism. Eur Thyroid J. 2013 Dec;2(4):215-28. doi: 10.1159/000356507. Epub 2013 Nov 27. Dostupné z DOI:http://doi.org/10.1159/000356507. Go to original source... Go to PubMed...
  15. Biondi B, Cappola AR. Subclinical hypothyroidism in older individuals. Lancet Diabetes Endocrinol. 2022 Feb;10(2):129-141. Dostupné z DOI:http://doi.org/10.1016/S2213-8587(21)00285-0 Go to original source... Go to PubMed...




Vnitřní lékařství

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.