Subclinical Hypothyroidism: An Update for Primary Care Physicians

Fatourechi, Vahab
January 2009
Mayo Clinic Proceedings;Jan2009, Vol. 84 Issue 1, p65
Academic Journal
Subclinical hypothyroidism (SCH), also called mild thyroid failure, is diagnosed when peripheral thyroid hormone levels are within normal reference laboratory range but serum thyroid-stimulating hormone (TSH) levels are mildly elevated. This condition occurs in 3% to 8% of the general population, it Is more common In women than men, and Its prevalence Increases with age. Of patients with SCH, 80% have a serum TSH of less than 10 mlU/L. The most Important Implication of SCH is high likelihood of progression to clinical hypothyroidism. The possibility that It Is a cardiovascular risk factor has been a subject of debate. Large-scale randomized studies are needed for evidence-based recommendations regarding screening for mild thyroid failure and levothyroxine therapy for this condition. Currently, the practical approach Is routine levothyroxine therapy for persons with a persistent serum TSH of more than 10.0 mlU/L and Individualized therapy for those with a TSH of less than 10.0 mlU/L.


Related Articles

  • Thyroid Disease in the Elderly. Part 1. Undiagnosed Hypothyroidism. Bemben, Debra A.; Winn, Peter; Hamm, Robert M.; Morgan, Leonard; Davis, Alan; Barton, Elaine // Journal of Family Practice;Jun1994, Vol. 38 Issue 6, p577 

    Background. The purpose of this study was to examine the prevalence of previously unrecognized hypothyroidism in elderly patients. Methods. The study was conducted in a primary care geriatrics clinic. Three hundred seventy elderly patients (287 women, 83 men) between 60 and 97 years of age were...

  • Thyroid Disease in the Elderly. Part 2. Predictability of Subclinical Hypothyroidism. Bemben, Debra A.; Hamm, Robert M.; Morgan, Leonard; Winn, Peter; Davis, Alan; Barton, Elaine // Journal of Family Practice;Jun1994, Vol. 38 Issue 6, p583 

    Background. The purpose of this study was to determine how well hypothyroidism could be predicted from clinical signs and symptoms in elderly patients with no known history of thyroid disease. Methods. This retrospective study was conducted in a primary care geriatrics clinic. Two hundred...

  • Central registers help reporting of hypothyroidism. Bowden, Rachel // GP: General Practitioner;12/2/2005, p13 

    The article reports that Great Britain registers find high levels of hypothyroidism. The Grampian and Tayside areas have centralised registers where all patients with thyroid disease are meant to be recorded. Higher prevalence of hypothyroidism based on quality framework data could be due to...

  • Thyroid Hormone Levels in Apparently Euthyroid Subjects with Essential Hypertension in a Tertiary Hospital in Nigeria. Emokpae, Abiodun Mathias; Abdu, Aliyu; Benedo Osadolor, Humphrey // Journal of Laboratory Physicians;Jan-Jun2013, Vol. 5 Issue 1, p26 

    Background: High blood pressure (BP) is a major health problem in Nigeria and the involvement of thyroid hormones in this condition has not been evaluated in this center. Objective: The objective of this study was to evaluate the proportion of patients with an essential hypertension who had...

  • Management of hypothyroidism in adults. Vaidya, Bijay; Pearce, Simon H. S. // BMJ: British Medical Journal (International Edition);8/2/2008, Vol. 337 Issue 7664, p284 

    Hypothyroidism is one of the commonest chronic disorders in Western populations. In the United Kingdom, the annual incidence of primary hypothyroidism in women is 3.5 per 1000 and in men 0.6 per 1000.' During 2006 12 million prescriptions for levothyroxine (50 |ig or 100 |xg tablets) were...

  • Should We Screen for Hypothyroidism in the Elderly? Zazove, Philip // Journal of Family Practice;Jun1994, Vol. 38 Issue 6, p571 

    The article discusses the need for screening hypothyroidism among the elderly patients. The author states that the significance of knowing the long-term implications of subclinical hypothyroidism is particularly relevant in the present health care environment. The author also mentions that...

  • Forgotten drugs: long-term prescriptions of thyroid hormones -- a cross-sectional study. Viniol, Annika; Bösner, Stefan; Baum, Erika; Donner-Banzhoff, Norbert // International Journal of General Medicine;Apr2013, Vol. 6, p329 

    Background:Thyroid hormones are among the most prescribed drugs in Germany. Although iodine supply has been improving in the last decade, annual prescriptions for thyroid hormones are rising. The aim of this study was to provide prevalence of thyroid hormone prescribing and to explore reasons...

  • Presenting results with confidence.  // Journal of Clinical Pathology;Dec2009, Vol. 62 Issue 12, p1059 

    No abstract available.

  • Levothyroxine Therapy in Patients with Thyroid Disease. Mandel, Susan J.; Brent, Gregory A.; Larsen, P. Reed // Annals of Internal Medicine;9/15/93, Vol. 119 Issue 6, p492 

    Discusses the indications for and the proper monitoring of levothyroxine therapy in patients with thyroid disease. Prevalence of overt hypothyroidism in women and men in the U.S; Information on thyroid hormone physiology and thyroid-pituitary regulation; Situations associated with...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics