Subclinical Thyroid Disease

Subclinical hypothyroidism (SH) is an entity that practically is diagnosed based on laboratory data because there are not clinical data or are minimal. Thus, subclinical hypothyroidism was defined as elevated thyroid stimulating hormone (TSH) above the normal range (0.45-4.5 mIU/L) with normal concentration of free thyroxine (FT4).

The prevalence of SH is 7.5 to 8.5% in women and 2.8 to 4.4% in men. SH increases its incidence after 60 years of age, so that in women at this stage of life is recorded up to 15% and in men up to 8%. SH patients develop permanent hypothyroidism at the rate of 4% per year.

Many studies have shown improvement in the clinical condition of patients receiving thyroid hormone replacement doses, with normalization of serum lipids and improvement in cardiovascular and neurological systems.

The literature review also shows that a high percentage of patients with subclinical or even with the overt form of hypothyroidism are not diagnosed and therefore not treated consequently developing major neuropsychiatric disorders as well as lipids and cardiovascular disease.

However, also through a systematic literature review is found that factors (cost/benefit) to be taken into account before initiating replacement therapy in the SH are:

1. Cost of not only drugs but also consultations and laboratory studies


2. Duration of therapy, because once started is difficult to discontinue it


3. Risk of exacerbation of preexisting heart disease in elderly patients

What Type Of Patients Should Be Performed TSH Test?

It is recommended practice Thyroid Stimulating Hormone (TSH) test in men and women aged 35 years old and measure free thyroxine (FT4) to those who have high TSH.

A doctor would treat with levothyroxine to patients with elevated TSH and normal or low FT4 with a dose to normalize TSH levels. Patients aged 60 years or a heart disease background only is considered the possibility of giving thyroid hormone therapy if the TSH is above 10 mU/L and a dose which would reduce TSH levels only about 6 mU/L.

In the case of women in gestational age or pregnant should be made appropriate testing regardless of age since early diagnosis allows us to establish the appropriate replacement therapy with levothyroxine and avoid fatigue, weakness, weight gain and edema in the mother and promote the proper neurological development of the product.

Since conventional medical treatment involves several types of complications can be considered various alternative treatments, mainly focused on nutrition and based on herbs that help in improving thyroid function.