Hypothyroidism

  • Medical Author:
    Ruchi Mathur, MD, FRCP(C)

    Ruchi Mathur, MD, FRCP(C) is an Attending Physician with the Division of Endocrinology, Diabetes and Metabolism and Associate Director of Clinical Research, Recruitment and Phenotyping with the Center for Androgen Related Disorders, Department of Obstetrics and Gynecology at Cedars-Sinai Medical Center.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

View the Hyperthyroidism Slideshow Pictures

Quick GuideThyroid Anatomy, Symptoms, and Disorders

Thyroid Anatomy, Symptoms, and Disorders

What is subclinical hypothyroidism?

Subclinical hypothyroidism refers to a state in which patients do not exhibit the symptoms of hypothyroidism. These patients also have a normal amount of circulating thyroid hormone. The only abnormality is an increased TSH on their blood work. This implies that the pituitary gland is working extra hard to maintain a normal circulating thyroid hormone level and that the thyroid gland requires extra stimulation by the pituitary to produce adequate hormones. The majority of these patients can be expected to progress to obvious hypothyroidism, especially if the TSH is above a certain level.

While there is some controversy, many endocrinologists will treat such patients, especially if they have a high cholesterol blood level. The abnormal cholesterol profile will likely show improvement with thyroid hormone replacement. If the cholesterol levels are normal, and the patient feels well, it is also reasonable to follow these patients without treatment and repeat the blood TSH and thyroid hormone levels in 4 to 6 months to see if more significant hypothyroidism is apparent. Both of these approaches are reasonable and patients should be encouraged to speak with their physicians about specific concerns and preferences.

What's best for you?

If you are concerned that you may have hypothyroidism, you should mention your symptoms to your physician. A simple blood test is the first step in the diagnosis. From there, both you and your doctor can decide what the next steps should be. If treatment is warranted, it is important for you to let your doctor know of any concerns or questions you have about the options available. Remember that thyroid disease is very common and, in good hands, hypothyroidism is easily addressed and treated.

Medically reviewed by John A. Seibel, MD; Board Certified Internal Medicine with a subspecialty in Endocrinology & Metabolism

REFERENCE:

UpToDate. Patient information: Hypothyroidism (underactive thyroid) (Beyond the Basics).

Medically Reviewed by James Felicetta, M.D. American Board of Internal Medicine with subspecialty in Endocrinology, Diabetes & Metabolism

Medically Reviewed by a Doctor on 7/28/2016

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