How should I manage someone with subclinical hypothyroidism who has a TSH less than 10 mU/L?
• In people with subclinical hypothyroidism with thyroid-stimulating hormone (TSH) concentration less than 10 mU/L. • Levothyroxine treatment is not routinely recommended. • Consider offering levothyroxine treatment if there is a goitre or the TSH level is rising. • Consider offering a trial of treatment to people who have symptoms compatible with hypothyroidism. • Prescribe treatment for a sufficient length of time to be able to judge whether there is symptomatic benefit. • Only continue treatment if there is a clear improvement in symptoms. • If treatment is not offered, it is still necessary to monitor thyroid function to detect progression to overt hypothyroidism. • If the person has serum thyroid peroxidase antibodies (TP0-Ab), measure serum TSH annually or earlier if symptoms develop. • Otherwise, measure serum TSH approximately every 3 years or earlier if symptoms develop.
