Management of Subclinical Hypothyroidism
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Treatment of subclinical hypothyroidism with levothyroxine may be of most benefit to patients with symptoms suggestive of hypothyroidism and those patients with thyroid-stimulating hormone (TSH) levels higher than 10 μIU per mL (10 mIU per L) or positive anti-thyroid peroxidase (TPO) antibodies. Levothyroxine is recommended for pregnant patients. For asymptomatic patients with TSH levels between 4.5 and 10 μIU per mL (4.5 and 10 mIU per L), treatment may not be beneficial, but their thyroid function should be monitored at six- to 12-month intervals. [Strength of recommendation: C, based on expert opinion and systematic reviews with troublesome heterogeneity of disease-oriented evidence]
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