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Subclinical Hypothyroidism

Several studies suggest that people who have subclinical hypothyroidism (blood tests demonstrating low thyroid function, but have no symptoms of low thyroid disease) should be given thyroid replacement medication.

THE NORMAL THYROID: The brain produces a hormone called TSH that stimulates the thyroid gland to produce thyroid hormones. To keep the thyroid gland from producing too much thyroid, the thyroid hormone called T4 keeps the brain to from producing more TSH.

TESTS TO DIAGNOSE LOW THYROID FYUCNTION: A blood test called TSH is the most dependable test to diagnose low thyroid function. People with low thyroid function usually have low blood levels of thyroid hormones, and very high levels of the brain hormone, TSH. Doctors diagnose low thyroid function when people have very high levels of the brain hormone, TSH and low levels of thyroid hormones.

SYMPTOMS OF LOW THROID FUNCTION: Most people who have high blood levels of TSH have signs of low thyroid function including tiredness, weakness, weight gain, and decreased deep tendon reflexes.

SUNBCLINICAL HYPOTHYROIDISM: Some people have high blood TSH levels, normal levels of thyroid hormones, and they also have no signs or symptoms of low thyroid function. Doctors call this subclinical hypothyroidism and they usually do not prescribe thyroid replacement pills. Now it appears that these people should also be treated with thyroid hormones, even if they have no symptoms of low thyroid function.

WHY PEOPLE WITH SUBCLINICAL HYPOTHYROIDISM SHOULD BE TREATED: A report from the University of Nebraska shows that people with an abnormal TSH thyroid test should receive thyroid pills, even if they have no symptoms of low thyroid function (1). This study showed that people with low TSH tests and no symptoms can have abnormal cholesterol levels as the only sign of low thyroid function.. See report #G171.1). Treatment with thyroid hormone was associated with fewer heart attacks and death during an eight-year period of observation in 40- to 70-year-old individuals with subclinical hypothyroidism, but not in those who were older than 70(2).

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1) Effects of subclinical hypothyroidism and its treatment on serum lipids. Annals of Pharmacotherapy, 2003, Vol 37, Iss 5, pp 725-730 BA Ineck, TMH Ng. Ng TMH, Univ Nebraska, Med Ctr, Dept Pharm Practice,986045 Nebraska Med Ctr, Omaha,NE 68198 USA
2) Archives of Internal Medicine April 24, 2012

Checked 5/26/12

May 30th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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