Subclinical hypothyroidism

Abstract

Subclinical hypothyroidism (SKH) is a thyroid disorder in which the level of thyroid hormones, thyroskin and triiodothyronine in the blood is normal, but the level of thyrotropin - TSH, pituitary hormone, which regulates the work of the thyroid gland with negative feedback, is elevated. This is a biochemical diagnosis, because patients are typically asymptomatic and without signs of disease and the detection of SCC is usually accidental. Gender, age, race, geographical area, iodine status. Depending on the degree of increase in baseline TSH levels, 5-8% of patients with SCH annually have progression to clinical hypothyroidism. Iodine is chronic autoimmune thyroiditis. Existing guidelines for the treatment of SKH differ from each other, as there is conflicting evidence on the benefits of long-term levothyroxine substitution in this condition. Although there are data from several comprehensive reviews of the clinical outcomes of SKH treatment, no definitive conclusion has yet been reached on the benefits of this approach. Factors that support application of levothyroxine therapy are: clinical trial due to symptoms of hypothyroidism, patient's desire, depression, infertility / ovulatory dysfunction, progressive increase in TSH, pregnancy, or pregnancy planning, children, adolescents. Research data show that pregnant women with SCC have an increased risk of gestational diabetes, miscarriage, gestational hypertension, preeclampsia, premature birth, and the therapeutic procedure in pregnancy differs from the rest of the adult population. The approach in children with SKH, amiodarone-induced SKH and micronutrients will be briefly mentioned.