Guidelines and recommendations on managing subclinical hypothyroidism
| Organization | Mild subclinical hypothyroidism (TSH 4.0–10.0 mIU/L) | Severe subclinical hypothyroidism (TSH > 10.0 mIU/L) | Key comments |
|---|---|---|---|
| US Preventive Services Task Force (2015)1 | Does not recommend routine screening or treatment | Recommends treatment | Insufficient evidence of benefit of treatment in patients without symptoms |
| European Thyroid Association (2013)10 | Watchful waiting, unless symptomatic Consider treatment in younger individuals with persistent symptoms | Recommends treatment | Emphasizes a cautious approach, especially in older adults |
| American Association of Clinical Endocrinology and American Thyroid Association (2012)2 | Does not recommend routine screening or treatment in patients without symptoms Consider treatment in select cases based on individual factors | Recommends treatment | Highlights individualizing treatment decisions and considering factors such as age, comorbidities, and symptom burden |
| American Thyroid Association (2014 update)3 | Similar to 2012 guidelines, emphasizing individualized approach | Recommends treatment, particularly in younger individuals and those with specific risk factors | Reinforces the importance of considering individual factors and the potential benefits of treatment in certain cases |
| American College of Physicians (2019)55 | Does not recommend routine screening or treatment unless symptoms are present | Recommends treatment | Emphasizes individualizing treatment based on patient factors |
| American Academy of Family Physicians (2021)54 | Does not recommend routine screening or treatment unless symptoms are present | Recommends treatment | Highlights the lack of evidence for routine screening and treatment in patients without symptoms |
TSH = thyroid-stimulating hormone