Subclinical Hypothyroidism: Prevalence, Health Impact, and Treatment Landscape
Subclinical hypothyroidism (sHypo) is defined as normal serum free thyroid hormone levels coexisting with elevated serum thyroid-stimulating hormone (TSH) levels. sHypo is a common condition observed in clinical practice with several unique features. Its diagnosis should be based on an understanding...
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| Format: | Article |
| Language: | English |
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Korean Endocrine Society
2021-06-01
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| Series: | Endocrinology and Metabolism |
| Subjects: | |
| Online Access: | http://www.e-enm.org/upload/pdf/enm-2021-1066.pdf |
| _version_ | 1811328559565766656 |
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| author | Won Sang Yoo Hyun Kyung Chung |
| author_facet | Won Sang Yoo Hyun Kyung Chung |
| author_sort | Won Sang Yoo |
| collection | DOAJ |
| description | Subclinical hypothyroidism (sHypo) is defined as normal serum free thyroid hormone levels coexisting with elevated serum thyroid-stimulating hormone (TSH) levels. sHypo is a common condition observed in clinical practice with several unique features. Its diagnosis should be based on an understanding of geographic and demographic differences in biochemical criteria versus a global reference range for TSH that is based on the 95% confidence interval of a healthy population. During the differential diagnosis, it is important to remember that a considerable proportion of sHypo cases are transient and reversible in nature; the focus is better placed on persistent or progressive forms, which mainly result from chronic autoimmune thyroiditis. Despite significant evidence documenting the health impacts of sHypo, the effects of levothyroxine treatment (LT4-Tx) in patients with sHypo remains controversial, especially in patients with grade 1 sHypo and older adults. Existing evidence suggests that it is reasonable to refrain from immediate LT4-Tx in most patients if they are closely monitored, except in women who are pregnant or in progressive cases. Future research is needed to further characterize the risks and benefits of LT4-Tx in different patient cohorts. |
| first_indexed | 2024-04-13T15:28:22Z |
| format | Article |
| id | doaj.art-e85d3938f1614c039ea23c3ecf73e23b |
| institution | Directory Open Access Journal |
| issn | 2093-596X 2093-5978 |
| language | English |
| last_indexed | 2024-04-13T15:28:22Z |
| publishDate | 2021-06-01 |
| publisher | Korean Endocrine Society |
| record_format | Article |
| series | Endocrinology and Metabolism |
| spelling | doaj.art-e85d3938f1614c039ea23c3ecf73e23b2022-12-22T02:41:27ZengKorean Endocrine SocietyEndocrinology and Metabolism2093-596X2093-59782021-06-0136350051310.3803/EnM.2021.10662181Subclinical Hypothyroidism: Prevalence, Health Impact, and Treatment LandscapeWon Sang Yoo0Hyun Kyung Chung1Division of Endocrinology and Metabolism, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, KoreaDivision of Endocrinology and Metabolism, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, KoreaSubclinical hypothyroidism (sHypo) is defined as normal serum free thyroid hormone levels coexisting with elevated serum thyroid-stimulating hormone (TSH) levels. sHypo is a common condition observed in clinical practice with several unique features. Its diagnosis should be based on an understanding of geographic and demographic differences in biochemical criteria versus a global reference range for TSH that is based on the 95% confidence interval of a healthy population. During the differential diagnosis, it is important to remember that a considerable proportion of sHypo cases are transient and reversible in nature; the focus is better placed on persistent or progressive forms, which mainly result from chronic autoimmune thyroiditis. Despite significant evidence documenting the health impacts of sHypo, the effects of levothyroxine treatment (LT4-Tx) in patients with sHypo remains controversial, especially in patients with grade 1 sHypo and older adults. Existing evidence suggests that it is reasonable to refrain from immediate LT4-Tx in most patients if they are closely monitored, except in women who are pregnant or in progressive cases. Future research is needed to further characterize the risks and benefits of LT4-Tx in different patient cohorts.http://www.e-enm.org/upload/pdf/enm-2021-1066.pdfsubclinical hypothyroidismdiagnosisprevalencetreatment |
| spellingShingle | Won Sang Yoo Hyun Kyung Chung Subclinical Hypothyroidism: Prevalence, Health Impact, and Treatment Landscape Endocrinology and Metabolism subclinical hypothyroidism diagnosis prevalence treatment |
| title | Subclinical Hypothyroidism: Prevalence, Health Impact, and Treatment Landscape |
| title_full | Subclinical Hypothyroidism: Prevalence, Health Impact, and Treatment Landscape |
| title_fullStr | Subclinical Hypothyroidism: Prevalence, Health Impact, and Treatment Landscape |
| title_full_unstemmed | Subclinical Hypothyroidism: Prevalence, Health Impact, and Treatment Landscape |
| title_short | Subclinical Hypothyroidism: Prevalence, Health Impact, and Treatment Landscape |
| title_sort | subclinical hypothyroidism prevalence health impact and treatment landscape |
| topic | subclinical hypothyroidism diagnosis prevalence treatment |
| url | http://www.e-enm.org/upload/pdf/enm-2021-1066.pdf |
| work_keys_str_mv | AT wonsangyoo subclinicalhypothyroidismprevalencehealthimpactandtreatmentlandscape AT hyunkyungchung subclinicalhypothyroidismprevalencehealthimpactandtreatmentlandscape |