Hypothyroidism (cont.)
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.
Hypothyroidism At A Glance
- Hypothyroidism refers to any state in which
thyroid hormone production is below normal.
- There are many disorders that result in
hypothyroidism.
- The thyroid gland is regulated by another
gland that is located in the brain, the pituitary.
- Hypothyroidism is a very common
condition.
- The symptoms of hypothyroidism are often
subtle.
- A blood test is used to confirm
hypothyroidism.
- With the exception of certain conditions, the
treatment of hypothyroidism requires life-long medication.
Last Editorial Review: 7/22/2008
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