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Subclinical hypothyroidism, outcomes and management guidelines: a narrative review and update of recent literature.

Lookup NU author(s): Dr Salman Razvi



This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


Subclinical hypothyroidism (SCH) is diagnosed when serum thyroid stimulation hormone (thyrotropin; TSH) levels are above the reference range, accompanied by levels of free thyroxine within its reference range. The management of SCH remains a diagnostic and therapeutic challenge despite many years of research relating to its epidemiology, aetiology, effectiveness of treatment and safety. European Thyroid Association (ETA) guidelines for the management of SCH were published almost a decade ago. This narrative review summarises the clinical literature relating to SCH and outcomes since the publication of these guidelines. Clinical evidence emerging during the previous decade generally supports the view that SCH is associated with adverse outcomes to an extent that is intermediate between euthyroidism and overt hypothyroidism although evidence that treatment with thyroid hormone replacement is beneficial is lacking. Accordingly, the rationale for the recommendations for intervention in the ETA guidelines based on the age of the patient, level of serum TSH, symptoms and comorbidities remains valid today.

Publication metadata

Author(s): Urgatz B, Razvi S

Publication type: Review

Publication status: Published

Journal: Current Medical Research and Opinion

Year: 2023

Volume: 39

Issue: 3

Pages: 351-365

Online publication date: 12/01/2023

Acceptance date: 15/12/2022

ISSN (print): 0300-7995

ISSN (electronic): 1473-4877

Publisher: Taylor and Francis


DOI: 10.1080/03007995.2023.2165811