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Latent Hypothyroidism in Adults
Jeannine Schübel1, Joachim Feldkamp, Antje Bergmann
1Technische Universität Dresden, Faculty of Medicine Carl Gustav Carus, Department of General Practice/MK3, Dresden, Germany; Municipal Hospital Bielefeld, Department for Endocrinology and Diabetes, Bielefeld, Germany; GesundheitsZentrum Kelkheim.
Deutsches Arzteblatt International
|July 8, 2017
Summary
Latent hypothyroidism affects 3-10% of people and is often diagnosed incidentally. Treatment with L-thyroxine is controversial, with limited proven benefits but potential risks like fractures.
Area of Science:
- Endocrinology
- Thyroidology
Background:
- Latent hypothyroidism affects 3-10% of the population, often remaining asymptomatic.
- Diagnosis frequently occurs incidentally during routine laboratory testing.
Purpose of the Study:
- To review the diagnosis and treatment of latent hypothyroidism.
Main Methods:
- Selective PubMed search for publications from January 2000 to July 2016.
- Inclusion of pertinent articles and guidelines on latent hypothyroidism.
Main Results:
- Diagnosis requires repeated TSH > 4.0 mU/L with normal fT4; autoimmune thyroiditis is a common cause.
- L-thyroxine supplementation is debated due to risks (e.g., fractures) and unproven benefits for morbidity, mortality, quality of life, or weight.
- Potential benefits observed in cardiac function (women) and vascular system; treatment generally indicated for TSH > 10.0 mU/L.
Conclusions:
- Limited data exist on clinical endpoints and side effects of L-thyroxine therapy.
- Physicians must individually assess risks and benefits before recommending treatment for latent hypothyroidism.
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