title: Subclinical hypothyroidism: the state of the art.
abstract: 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.
authors.affiliation: Department of Pediatrics, University of Messina, Messina, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Arrigo
authors.forename: M
authors.initials: M
authors.lastname: Wasniewska
authors.forename: G
authors.initials: G
authors.lastname: Crisafulli
authors.forename: F
authors.initials: F
authors.lastname: Lombardo
authors.forename: M F
authors.initials: MF
authors.lastname: Messina
authors.forename: I
authors.initials: I
authors.lastname: Rulli
authors.forename: G
authors.initials: G
authors.lastname: Salzano
authors.forename: M
authors.initials: M
authors.lastname: Valenzise
authors.forename: G
authors.initials: G
authors.lastname: Zirilli
authors.forename: F
authors.initials: F
authors.lastname: De Luca
mesh_terms: 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