When to treat mild hypothyroidism

Alejandro R Ayala, M. D. Danese, P. W. Ladenson

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

The availability and wide acceptance of TSH assays for primary assessment of thyroid function has led to the recognition that mild thyroid hormone deficiency is characterized by elevation of the serum TSH concentration despite a normal free thyroxine level. Other conditions can also cause isolated serum TSH elevation, and these conditions can be distinguished from mild thyroid failure usually based on clinical and circumstantial observations alone. Thyroxine treatment of patients with mild hypothyroidism has been shown in most, but not all, clinical trials to lower atherogenic lipid levels and relieve certain somatic and neuropsychiatric symptoms. Such treatment also prevents the progression to overt hypothyroidism, which is particularly likely in patients who are older, who have circulating thyroid autoantibodies, or who have a serum TSH greater than 10 mU/L. After the optimal thyroxine dose has been defined, long-term monitoring of patients with an annual clinical evaluation and serum TSH measurement is appropriate. The high prevalence of mild hypothyroidism, particularly in older women, and its subtle clinical presentation have led some authorities to recommend a low threshold for case-finding or routine population screening for the disorder.

Original languageEnglish
Pages (from-to)399-415
Number of pages17
JournalEndocrinology and Metabolism Clinics of North America
Volume29
Issue number2
StatePublished - Jul 3 2000
Externally publishedYes

Fingerprint

Hypothyroidism
Thyroxine
Thyroid Gland
Serum
Thyroid Hormones
Autoantibodies
Assays
Screening
Physiologic Monitoring
Availability
Lipids
Monitoring
Clinical Trials
Therapeutics
Population

ASJC Scopus subject areas

  • Endocrinology
  • Biochemistry

Cite this

When to treat mild hypothyroidism. / Ayala, Alejandro R; Danese, M. D.; Ladenson, P. W.

In: Endocrinology and Metabolism Clinics of North America, Vol. 29, No. 2, 03.07.2000, p. 399-415.

Research output: Contribution to journalArticle

Ayala, AR, Danese, MD & Ladenson, PW 2000, 'When to treat mild hypothyroidism', Endocrinology and Metabolism Clinics of North America, vol. 29, no. 2, pp. 399-415.
Ayala, Alejandro R ; Danese, M. D. ; Ladenson, P. W. / When to treat mild hypothyroidism. In: Endocrinology and Metabolism Clinics of North America. 2000 ; Vol. 29, No. 2. pp. 399-415.
@article{82e7d6182d3846e8825156b96fee65d5,
title = "When to treat mild hypothyroidism",
abstract = "The availability and wide acceptance of TSH assays for primary assessment of thyroid function has led to the recognition that mild thyroid hormone deficiency is characterized by elevation of the serum TSH concentration despite a normal free thyroxine level. Other conditions can also cause isolated serum TSH elevation, and these conditions can be distinguished from mild thyroid failure usually based on clinical and circumstantial observations alone. Thyroxine treatment of patients with mild hypothyroidism has been shown in most, but not all, clinical trials to lower atherogenic lipid levels and relieve certain somatic and neuropsychiatric symptoms. Such treatment also prevents the progression to overt hypothyroidism, which is particularly likely in patients who are older, who have circulating thyroid autoantibodies, or who have a serum TSH greater than 10 mU/L. After the optimal thyroxine dose has been defined, long-term monitoring of patients with an annual clinical evaluation and serum TSH measurement is appropriate. The high prevalence of mild hypothyroidism, particularly in older women, and its subtle clinical presentation have led some authorities to recommend a low threshold for case-finding or routine population screening for the disorder.",
author = "Ayala, {Alejandro R} and Danese, {M. D.} and Ladenson, {P. W.}",
year = "2000",
month = "7",
day = "3",
language = "English",
volume = "29",
pages = "399--415",
journal = "Endocrinology and Metabolism Clinics of North America",
issn = "0889-8529",
publisher = "W.B. Saunders Ltd",
number = "2",

}

TY - JOUR

T1 - When to treat mild hypothyroidism

AU - Ayala, Alejandro R

AU - Danese, M. D.

AU - Ladenson, P. W.

PY - 2000/7/3

Y1 - 2000/7/3

N2 - The availability and wide acceptance of TSH assays for primary assessment of thyroid function has led to the recognition that mild thyroid hormone deficiency is characterized by elevation of the serum TSH concentration despite a normal free thyroxine level. Other conditions can also cause isolated serum TSH elevation, and these conditions can be distinguished from mild thyroid failure usually based on clinical and circumstantial observations alone. Thyroxine treatment of patients with mild hypothyroidism has been shown in most, but not all, clinical trials to lower atherogenic lipid levels and relieve certain somatic and neuropsychiatric symptoms. Such treatment also prevents the progression to overt hypothyroidism, which is particularly likely in patients who are older, who have circulating thyroid autoantibodies, or who have a serum TSH greater than 10 mU/L. After the optimal thyroxine dose has been defined, long-term monitoring of patients with an annual clinical evaluation and serum TSH measurement is appropriate. The high prevalence of mild hypothyroidism, particularly in older women, and its subtle clinical presentation have led some authorities to recommend a low threshold for case-finding or routine population screening for the disorder.

AB - The availability and wide acceptance of TSH assays for primary assessment of thyroid function has led to the recognition that mild thyroid hormone deficiency is characterized by elevation of the serum TSH concentration despite a normal free thyroxine level. Other conditions can also cause isolated serum TSH elevation, and these conditions can be distinguished from mild thyroid failure usually based on clinical and circumstantial observations alone. Thyroxine treatment of patients with mild hypothyroidism has been shown in most, but not all, clinical trials to lower atherogenic lipid levels and relieve certain somatic and neuropsychiatric symptoms. Such treatment also prevents the progression to overt hypothyroidism, which is particularly likely in patients who are older, who have circulating thyroid autoantibodies, or who have a serum TSH greater than 10 mU/L. After the optimal thyroxine dose has been defined, long-term monitoring of patients with an annual clinical evaluation and serum TSH measurement is appropriate. The high prevalence of mild hypothyroidism, particularly in older women, and its subtle clinical presentation have led some authorities to recommend a low threshold for case-finding or routine population screening for the disorder.

UR - http://www.scopus.com/inward/record.url?scp=0034116768&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034116768&partnerID=8YFLogxK

M3 - Article

VL - 29

SP - 399

EP - 415

JO - Endocrinology and Metabolism Clinics of North America

JF - Endocrinology and Metabolism Clinics of North America

SN - 0889-8529

IS - 2

ER -