Sub-clinical Hypothyroidism

 

Dr. Sanoop Kumar Sherin Sabu , MBBS., (M.D  Gen. Med. Resident)

(skssabu@gmail.com)

Clinical  features requiring treatment

·         personal history or family history of autoimmune disease

·         on drugs like (interferon, tyrosine kinase inhibitors, lithium and amiodarone)

·         concurrent comorbidities like atherosclerotic cardiovascular disease, heart failure, dyslipidemia, infertility, and refractory anemia

·         Those with  non specific neuropsychiatric disorders should be given a trial of levothyroxine for 3–6 months

·         weight gain after ruling out other causes

·         menorrhagia, infertility, galactorrhea, recurrent miscarriages, multicystic ovaries,

·         pericardial effusion, sinus bradycardia,

·         carpal tunnel syndrome, dementia, ataxia, and depressive disorders

Monitoring of  patients with subclinical hypothyroidism

·         Serum TSH should be monitored in patients with subclinical hypothyroidism, who are on treatment with levothyroxine. TSH should be targeted between 0.5 and 2.5 μIU/ml.

·         Those who are not on treatment should undergo regular surveillance of TSH every 6 months.

·         Overtreatment is to be avoided as it may result in decreased bone mineral density and increased risk of atrial fibrillation.

 

18-03-2021