Replacement Therapy with L-Thyroxine in Subclinical Hypothyroidism

german translation / full article

Andreas Sönnichsen

QuestionSome authors recommend screening of TSH and replacement therapy with l-thyroxine if TSH > 4 mU/l, because subclinical hypothyroidism is said to be associated with increased cardiovascular risk. Are there studies providing reliable evidence to support this recommendation?AnswerCurrent best evidence does not support routine TSH-screening to detect subclinical hypothyroidism in asymptomatic subjects. Also, there is no reliable evidence from clinical studies justifying the recommendation of replacement therapy with l-thyroxine in asymptomatic subjects with subclinical hypothyroidism, especially not for older people and people with TSH < 10 mU/l.

(State: 15.02.2018)

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