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Treatment of subclinical hypothyroidism: assessing when treatment is likely to be beneficial

Lookup NU author(s): Dr Salman Razvi



This is the authors' accepted manuscript of a review published in its final definitive form in 2021. For re-use rights please refer to the publishers terms and conditions.


Introduction: Subclinical hypothyroidism (SCH) is a common condition diagnosed in up to 16% of the population. SCH is diagnosed when serum TSH is high and circulating thyroid hormones are within the reference range. SCH is considered to be a mild form of thyroid failure by some due to the log-linear relationship between TSH and thyroid hormones. Nevertheless, it is unclear whether the treatment of SCH with thyroid hormones is beneficial, and hence, it is not surprising that expert opinions and recommendations from societies differ in their opinions on how best to manage SCH.Areas covered: This article reviews the currently available evidence pertaining to SCH and provides recommendations as to when treatment of SCH should be considered. An electronic search of PubMed from 1970 to 2019 was performed and systematically reviewed studies assessing the effects of treat- ment in SCH. The main areas that are considered are the effects of treatment on symptoms and quality of life, and important clinical consequences including psychocognitive outcomes and cardiovascular events.Expert opinion: Treatment of SCH with thyroid hormones is debated and the current literature in this area lacks clarity. We provide an evidence-based recommendation for when treatment of SCH with thyroid hormones should be considered.

Publication metadata

Author(s): Leng O, Razvi S

Publication type: Review

Publication status: Published

Journal: Expert Review of Endocrinology and Metabolism

Year: 2021

Volume: 16

Issue: 2

Pages: 73-86

Online publication date: 05/03/2020

Acceptance date: 03/03/2020

ISSN (print): 1744-6651

ISSN (electronic): 1744-8417


DOI: 10.1080/17446651.2020.1738924