Priority Programme: THYROID TRANS ACT
Translation of Thyroid Hormone Actions beyond Classical Concepts

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Subclinical Hypothyroidism - European Guidelines for managing subclinical thyroid condition were published in September 2013

The recent guidelines published by the European Thyroid Association (ETA) offer advice to patients and attending doctors

Between 4 and 10 percent of the general population suffer from Subclinical Hypothyroidism (SCH). The ETA has recently conducted studies on possible health risks associated with this condition, and published the results in form of guidelines to be followed by medical professionals. According to meta analyses by the ETA, SCH is typically associated with clinical conditions like mood disturbances, goitre, and thyroid cancer, and with obesity, diabetes mellitus, dyslipidaemia, or cardiovascular disease.

The ETA guidelines provide hints if and when specific thyroid condition might require treatment. Important is to keep in mind that therapy should be planned in accordance with patients age and severity of the condition.

SCH is classified into two categories, according to the individual’s levels of the hormone TSH: Mildly increased TSH levels (concentration below 10 mU/l) in adults do not require immediate treatment if the patient does not show symptoms of hypothyroidism, but monitoring of the condition in regular intervals is strongly recommended.

In case of more severely increased TSH levels (concentration above 10 mU/l), the ETA guidelines recommend treatment by hormone replacement therapy, thus with the thyroid hormone LT4. If patients are older than 70 years, treatment of more severely increased TSH levels is advised, and only when patients show clear symptoms of hypothyroidism, or are at risk of vascular disease. The ETA guidelines, however, do not comprehend diagnosis and treatment of women in pregnancy and children.

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