Ipotiroidismo subclinico: realtà e falsi miti

Abstract

Subclinical hypothyroidism (SH, or hyperthyrotropinemia) is a biochemical condition defined as elevated serum TSH concentrations and normal thyroxine (FT4). Generally, it is asymptomatic, and it distinguished in mild (TSH between the upper limit and 9.9 μUI/ml) and severe (TSH 10 μUI/ml or higher). Replacement L-thyroxine treatment is requested for the severe form, while mild form treatment is still debated. In children, SH is usually a benign and remitting condition and progression to overt hypothyroidism is uncommon. By contrast, the risk of a deterioration of thyroid status is higher in children with SH and Hashimoto’s thyroiditis or chromosomal abnormalities, such as Turner syndrome or trisomy 21. Thyroid function is implicated in many aspects of growth and development; therefore, it is important to evaluate whether untreated hyperthyrotropinemia has long-term consequences. On the contrary, mild thyroid disfunction is improperly considered the cause of some clinical issues, such as obesity, sleep disorders and constipation.