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Subclinical hypothyroidism: The state of the art

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Abstract

Subclinical hypothyroidism (SH) is a common clinical problem, particularly in adulthood and the elderly. Its prevalence is conditioned by several etiological and risk factors. The highest age- and sex-specific rates are in women over 60. SH may be associated with manifestations of mild thyroid failure, which may reverse under levothyroxine (L-T4) therapy. The risk of progression to overt hypothyroidism is distinctly higher in cases with underlying thyroid disease. A population routine screening is not generally recommended, but screening is encouraged in high-risk groups. L-T4 therapy may be indicated in subjects with TSH levels which are repeatedly and consistently elevated (>10 μIU/ml) and may be considered in those with TSH ranging between 4.5–5.5 and 10 μIU/ml, particularly if anti-thyroid antibodies are positive and/or hypothyroid symptoms are present. Treatment should be based, at least initially, on L-T4 low doses.

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Authors and Affiliations

  1. Department of Pediatrics, University of Messina, Italy

    T. Arrigo, M. Wasniewska, G. Crisafulli, F. Lombardo, M. F. Messina, I. Rulli, G. Salzano, M. Valenzise, G. Zirilli & F. De Luca MD

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  1. T. Arrigo
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  2. M. Wasniewska
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  3. G. Crisafulli
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Correspondence to F. De Luca MD.

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Arrigo, T., Wasniewska, M., Crisafulli, G. et al. Subclinical hypothyroidism: The state of the art. J Endocrinol Invest 31, 79–84 (2008). https://doi.org/10.1007/BF03345571

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