Subclinical Hypothyroidism: The evidence suggests that treatment is not indicated, consensus guidelines and clinician judgment may sometimes say otherwise.

Abstract

Subclinical hypothyroidism is defined as an elevated thyroid stimulating hormone (TSH) and a normal T4 in the presence of few or no hypothyroid symptoms. It is a frequently encountered clinical scenario. Often the clinician is faced with the decision of treatment vs. no treatment. A recent review of the evidence produced guidelines on management of this condition. Essentially there is insufficient evidence to support treatment in most cases; however these guidelines recommend treatment if the hypothyroid patient is symptomatic or if TSH is over 10.