In Reply: Most elderly patients with subclinical hypothyroidism do not need to be treated

  • Cleveland Clinic Journal of Medicine
  • July 2025,
  • 92
  • (7)
  • 395;
  • DOI: https://doi.org/10.3949/ccjm.92c.07002

We appreciate Dr. Selinger’s insightful observations regarding the overtreatment of patients with subclinical hypothyroidism. His emphasis on the potential harms associated with overtreatment is particularly valuable. The issue of overprescribing levothyroxine, especially in patients under 65 with normal thyrotropin levels or mild subclinical hypothyroidism, by practitioners outside of primary care or endocrinology indeed warrants further investigation. We agree that this topic deserves a dedicated and comprehensive review in the future.

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