Subclinical hypothyroidism: the state of the art.
Subclinical hypothyroidism (SH) is a common clinical problem, particularly in adulthood and the elderly. Its prevalence is conditioned by several etiological and risk factors. The highest age- and sex-specific rates are in women over 60. SH may be associated with manifestations of mild thyroid failure, which may reverse under levothyroxine (L-T4) therapy. The risk of progression to overt hypothyroidism is distinctly higher in cases with underlying thyroid disease. A population routine screening is not generally recommended, but screening is encouraged in high-risk groups. L-T4 therapy may be indicated in subjects with TSH levels which are repeatedly and consistently elevated (>10 microIU/ml) and may be considered in those with TSH ranging between 4.5-5.5 and 10 microIU/ml, particularly if anti-thyroid antibodies are positive and/or hypothyroid symptoms are present. Treatment should be based, at least initially, on L-T4 low doses.
Arrigo
T
T
Department of Pediatrics, University of Messina, Messina, Italy.
Wasniewska
M
M
Crisafulli
G
G
Lombardo
F
F
Messina
M F
MF
Rulli
I
I
Salzano
G
G
Valenzise
M
M
Zirilli
G
G
De Luca
F
F
D000465:Algorithms; D018450:Disease Progression; D042241:Early Diagnosis; D006801:Humans; D007037:Hypothyroidism / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D015995:Prevalence; D012307:Risk Factors; D013960:Thyroid Function Tests