Natural history of subclinical hypothyroidism with TSH ≤10 mIU/l: a prospective study

Clinical Endocrinology
Pedro Weslley RosarioMaria Regina Calsolari

Abstract

The risk of progression of subclinical hypothyroidism (SCH) to clinical dysfunction is one of the factors considered in the decision to treat this condition. This study evaluated the natural history of SCH in women with TSH ≤10 mIU/l. This is a prospective study. Two hundred and fifty-two women with SCH and TSH levels ranging from 4·5 to 10 mIU/l were followed up for a period of 5 years. Among the 241 patients followed up until the completion of the study, 46 (19%) required levothyroxine (L-T4) therapy, 55 (22·8%) had spontaneous normalization of serum TSH, and 140 (58·1%) continued to meet the criteria for mild SCH. In multivariate analysis, only initial TSH >8 mIU/l was a predictor of the need for L-T4. In contrast, initial TSH ≤8 mIU/l and the absence of thyroiditis [negative antithyroid peroxidase antibodies (TPOAb) and ultrasonography (US)] were predictors of TSH normalization. Of note, the natural history was similar in TPOAb-positive patients and patients with negative TPOAb but with positive US. Most women with mild elevation of serum TSH, ranging from 4·5 to 10 mIU/l, do not progress to overt hypothyroidism and even normalize their TSH. However, initial TSH seems to be a more important predictor of progression than the...Continue Reading

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Citations

Aug 16, 2016·Clinical Endocrinology·Pedro W Rosario, Maria R Calsolari
May 24, 2018·Archives of Endocrinology and Metabolism·Pedro Weslley Rosario, Maria Regina Calsolari
Oct 24, 2018·Thyroid : Official Journal of the American Thyroid Association·Sarantis LivadasLeonidas H Duntas
Mar 9, 2018·Endocrine Connections·Jeonghoon HaMin-Hee Kim
Jul 19, 2019·PloS One·Michael W DzierlengaMatthew P Longnecker
Oct 17, 2019·Endocrine·Flavia MagriMario Rotondi
Jul 3, 2020·International Journal of Endocrinology·Laura Pérez-Campos MayoralEduardo Pérez-Campos
Feb 27, 2018·The Journal of Clinical Endocrinology and Metabolism·Mary H Samuels
Aug 30, 2018·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Lesley RobertsFd Richard Hobbs
Oct 6, 2017·The New England Journal of Medicine·Pedro W Rosario
Sep 11, 2019·Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Métabolisme·Stefanie ReckerDagmar Führer

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