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Subclinical Hypothyroidism

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1. General medicine: Low-dose levothyroxine did not improve symptoms in asymptomatic older people with subclinical hypothyroidism

General medicine: Low-dose levothyroxine did not improve symptoms in asymptomatic older people with subclinical hypothyroidism Low-dose levothyroxine did not improve symptoms in asymptomatic older people with subclinical hypothyroidism | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using your (...) username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Low-dose levothyroxine did not improve symptoms in asymptomatic older people with subclinical hypothyroidism Article Text Commentary General medicine Low

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2018 Evidence-Based Medicine (Requires free registration)

2. Exercise training improves quality of life in women with subclinical hypothyroidism: a randomized clinical trial. (PubMed)

Exercise training improves quality of life in women with subclinical hypothyroidism: a randomized clinical trial. The aim was to evaluate the quality of life (HRQoL) in women with subclinical hypothyroidism (sHT) after 16 weeks of endurance training.In the first phase, a cross-sectional study was conducted in which 22 women with sHT (median age: 41.5 (interquartile range: 175) years, body mass index: 26.2 (8.7) kg/m2, thyroid stimulating hormone > 4.94 mIU/L and free thyroxine between 0.8

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2018 Archives of endocrinology and metabolism

3. Subclinical Hypothyroidism in Women Planning Conception and During Pregnancy: Who Should Be Treated and How? (PubMed)

Subclinical Hypothyroidism in Women Planning Conception and During Pregnancy: Who Should Be Treated and How? Subclinical hypothyroidism (SCH), a mild form of hypothyroidism defined as elevated TSH with normal free thyroxine levels, is a common diagnosis among women of reproductive age. In some, but not all, studies, it has been associated with infertility, an increased risk of adverse pregnancy and neonatal outcomes, and possibly with an increased risk of neurocognitive deficits in offspring (...) . Despite well-established recommendations on treatment of overt hypothyroid pregnant women, a consensus has not yet been reached on whether to treat women with SCH. This review focuses on examining the evidence informing the clinical strategy for using levothyroxine (LT4) in women with SCH during pregnancy and those who are planning conception. A crucial first step is to accurately diagnose SCH using the appropriate population-based reference range. For pregnant women, if this is unavailable

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2018 Journal of the Endocrine Society

4. Subclinical hypothyroidism in children: is it always subclinical? (PubMed)

Subclinical hypothyroidism in children: is it always subclinical? Aim of this commentary is to report current knowledges on the main clinical and metabolic abnormalities which might be observed in children with longstanding and untreated subclinical hypothyroidism (SH) and to comment the most recent views about natural evolution of thyroid function in the cases with either idiopathic or Hashimoto's thyroiditis-related SH. On the basis of these preliminary remarks, the essential guidelines

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2018 Italian journal of pediatrics

5. Relation of Subclinical Hypothyroidism is Associated With Cardiovascular Events and All-Cause Mortality in Adults With High Cardiovascular Risk

Relation of Subclinical Hypothyroidism is Associated With Cardiovascular Events and All-Cause Mortality in Adults With High Cardiovascular Risk The aim of this study was to determine the association between subclinical hypothyroidism and cardiovascular (CVD) events, and mortality using the atherosclerotic CVD risk score. We carried out an observational study in a prospective cohort that was followed up for 12 years. The study included 3,021 participants aged ≥ 40 years at baseline from (...) the Ansung cohort, part of the Korean Genome and Epidemiology Study. Cox regression models were constructed to evaluate the hazards ratio (HR) and 95% confidence interval (CI) for all-cause mortality and CVD events in groups classified according to thyroid status. Subgroup analysis was performed with a cut-off age of 65 years or 7.5% of the 10-year atherosclerotic CVD risk score. The subclinical hypothyroidism group in the highest quartile of thyroid-stimulating hormone (>6.57 mIU/L) had a significantly

2018 EvidenceUpdates

6. Association of Thyroid Hormone Therapy With Quality of Life and Thyroid-Related Symptoms in Patients With Subclinical Hypothyroidism: A Systematic Review and Meta-analysis. (PubMed)

Association of Thyroid Hormone Therapy With Quality of Life and Thyroid-Related Symptoms in Patients With Subclinical Hypothyroidism: A Systematic Review and Meta-analysis. The benefit of thyroid hormone therapy for subclinical hypothyroidism is uncertain. New evidence from recent large randomized clinical trials warrants an update of previous meta-analyses.To conduct a meta-analysis of the association of thyroid hormone therapy with quality of life and thyroid-related symptoms in adults (...) with subclinical hypothyroidism.PubMed, EMBASE, ClinicalTrials.gov, Web of Science, Cochrane Library, CENTRAL, Emcare, and Academic Search Premier from inception until July 4, 2018.Randomized clinical trials that compared thyroid hormone therapy with placebo or no therapy in nonpregnant adults with subclinical hypothyroidism were eligible. Two reviewers independently evaluated eligibility based on titles and abstracts of all retrieved studies. Studies not excluded in this first step were independently assessed

2018 JAMA

7. Soy Protein Improves Cardiovascular Risk in Subclinical Hypothyroidism: A Randomized Double-Blinded Crossover Study (PubMed)

Soy Protein Improves Cardiovascular Risk in Subclinical Hypothyroidism: A Randomized Double-Blinded Crossover Study Soy protein with isoflavones appears to have an adverse effect on thyroid function, but it is not known whether it is the protein or isoflavone component that is deleterious. The effect of isoflavone-free soy on thyroid function was determined in patients with subclinical hypothyroidism, with a secondary aim of assessing its effect on cardiovascular risk indices.This (...) was a randomized, double-blind, crossover study involving 80 patients with subclinical (compensated) hypothyroidism. Patients were randomly assigned to either isolated soy (isoflavone-free) protein (SP) or casein protein (CP) supplementation for 8 weeks, washed out for 8 weeks, and then crossed over for a further 8-week period.Thyroid function was unaffected by either a SP or CP. There were significant decreases in fasting glucose (4.7 ± 0.6 vs 5.5 ± 1.4, P < 0.01), insulin resistance (3.3 ± 3.0 vs 3.8 ± 3.4

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2017 Journal of the Endocrine Society

8. The Effect of Early Substitution of Subclinical Hypothyroidism on Biochemical Blood Parameters and the Quality of Life (PubMed)

The Effect of Early Substitution of Subclinical Hypothyroidism on Biochemical Blood Parameters and the Quality of Life Subclinical hypothyroidism (SCH) is defined as high TSH and normal thyroxine. Data on the effects of early substitution by levothyroxine on psychophysical health in SCH are still not consistent enough to support its introduction.Clinical parameters, biochemical data and quality of life (Short Form 36 questionnaire) were measured before the intervention and 3 months after (...) dimensions of mental health (r=0.376, p=0.026). With increasing doses of levothyroxine, the previously listed scores of SF 36 grew (r=0.296, p=0.084).Early substitution of SCH improved the many clinical and biochemical parameters related to cardiovascular risk. Quality of life was also improved, and correlated only with thyroxine doses suggesting an indirect relationship between the degree of hypothyroidism and quality of life.

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2017 Journal of medical biochemistry

9. Impact of Subclinical Hypothyroidism on Cardiometabolic Biomarkers in Women (PubMed)

Impact of Subclinical Hypothyroidism on Cardiometabolic Biomarkers in Women Whether subclinical hypothyroidism (SCH) is associated with cardiometabolic abnormalities is uncertain.To examine diverse cardiometabolic biomarkers across euthyroid, SCH, and overt hypothyroidism (HT) in women free of cardiovascular disease (CVD).Cross-sectional adjusted associations for lipids, lipoprotein subclasses, lipoprotein insulin resistance score, inflammatory, coagulation, and glycemic biomarkers by ANCOVA

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2017 Journal of the Endocrine Society

10. The effectiveness of thyroid hormone therapy in patients with subclinical hypothyroidism: a systematic review and meta-analysis

The effectiveness of thyroid hormone therapy in patients with subclinical hypothyroidism: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any

2019 PROSPERO

11. Linear and nonlinear analyses of heart rate variability following orthostatism in subclinical hypothyroidism. (PubMed)

Linear and nonlinear analyses of heart rate variability following orthostatism in subclinical hypothyroidism. Subclinical hypothyroidism (SCHypo) is associated with autonomic disturbances that can interfere in physiological responses. This study was designed to evaluate linear and nonlinear variables of heart rate variability (HRV) following postural change, comparing subjects with SCHypo to euthyroid subjects.HRV analyses were performed in 5-minute time series collected in the supine

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2019 Medicine

12. Association between subclinical hypothyroidism and depression: an updated systematic review and meta-analysis. (PubMed)

Association between subclinical hypothyroidism and depression: an updated systematic review and meta-analysis. Although depression is associated with changes in the hypothalamic-pituitary-thyroid axis, its relationship with subclinical hypothyroidism (SCH) is controversial. To date, there is a lack of data on the improvement of depressive symptoms with levothyroxine therapy among individuals with coexistent SCH.We conducted a meta-analysis to evaluate the association between SCH and depression

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2019 BMC Psychiatry

13. Thyroid hormone treatment among pregnant women with subclinical hypothyroidism: US national assessment. (PubMed)

Thyroid hormone treatment among pregnant women with subclinical hypothyroidism: US national assessment.  To estimate the effectiveness and safety of thyroid hormone treatment among pregnant women with subclinical hypothyroidism. Retrospective cohort study. Large US administrative database between 1 January 2010 and 31 December 2014. 5405 pregnant women with subclinical hypothyroidism, defined as untreated thyroid stimulating hormone (TSH) concentration 2.5-10 mIU/L. Thyroid hormone therapy (...) . Pregnancy loss and other pre-specified maternal and fetal pregnancy related adverse outcomes. Among 5405 pregnant women with subclinical hypothyroidism, 843 with a mean pre-treatment TSH concentration of 4.8 (SD 1.7) mIU/L were treated with thyroid hormone and 4562 with a mean baseline TSH concentration of 3.3 (SD 0.9) mIU/L were not treated (P<0.01). Pregnancy loss was significantly less common among treated women (n=89; 10.6%) than among untreated women (n=614; 13.5%) (P<0.01). Compared

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2017 BMJ

14. Thyroid Hormone Therapy for Older Adults with Subclinical Hypothyroidism. (PubMed)

Thyroid Hormone Therapy for Older Adults with Subclinical Hypothyroidism. The use of levothyroxine to treat subclinical hypothyroidism is controversial. We aimed to determine whether levothyroxine provided clinical benefits in older persons with this condition.We conducted a double-blind, randomized, placebo-controlled, parallel-group trial involving 737 adults who were at least 65 years of age and who had persisting subclinical hypothyroidism (thyrotropin level, 4.60 to 19.99 mIU per liter (...) prespecified as being of special interest.Levothyroxine provided no apparent benefits in older persons with subclinical hypothyroidism. (Funded by European Union FP7 and others; TRUST ClinicalTrials.gov number, NCT01660126 .).

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2017 NEJM

15. Treatment of Subclinical Hypothyroidism or Hypothyroxinemia in Pregnancy. (PubMed)

Treatment of Subclinical Hypothyroidism or Hypothyroxinemia in Pregnancy. Subclinical thyroid disease during pregnancy may be associated with adverse outcomes, including a lower-than-normal IQ in offspring. It is unknown whether levothyroxine treatment of women who are identified as having subclinical hypothyroidism or hypothyroxinemia during pregnancy improves cognitive function in their children.We screened women with a singleton pregnancy before 20 weeks of gestation for subclinical (...) a normal thyrotropin or free T4 level (depending on the trial), with sham adjustments for placebo. Children underwent annual developmental and behavioral testing for 5 years. The primary outcome was the IQ score at 5 years of age (or at 3 years of age if the 5-year examination was missing) or death at an age of less than 3 years.A total of 677 women with subclinical hypothyroidism underwent randomization at a mean of 16.7 weeks of gestation, and 526 with hypothyroxinemia at a mean of 17.8 weeks

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2017 NEJM

16. Subclinical hypothyroidism: When to treat. (PubMed)

Subclinical hypothyroidism: When to treat. Subclinical hypothyroidism is defined by an elevated serum thyroid-stimulating hormone (TSH) level along with a normal free thyroxine (T4) level. Whether it should be treated remains controversial. Currently, the best practical approach is to base treatment decisions on the degree of TSH elevation, thyroid autoimmunity, and associated comorbidities.Copyright © 2019 Cleveland Clinic.

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2019 Cleveland Clinic Journal of Medicine

17. Effect of levothyroxine supplementation on pregnancy loss and preterm birth in women with subclinical hypothyroidism and thyroid autoimmunity: a systematic review and meta-analysis. (PubMed)

Effect of levothyroxine supplementation on pregnancy loss and preterm birth in women with subclinical hypothyroidism and thyroid autoimmunity: a systematic review and meta-analysis. Subclinical hypothyroidism (SCH) and thyroid autoimmunity (TAI) are associated with adverse pregnancy outcomes such as pregnancy loss and preterm birth. However, the ability of levothyroxine (LT4) supplementation to attenuate the risks of these outcomes remains controversial.This systematic review and meta-analysis (...) was conducted to determine the effect of LT4 supplementation on pregnancy loss rate (PLR) and preterm birth rate (PBR) among pregnant women with SCH and TAI.A systematic literature search of the PubMed, EMBASE, Web of Science and Cochrane Controlled Trials Register databases and Clinicaltrials.gov was performed to identify all relevant English studies published up to April 2018. The following terms were used for the search: [subclinical hypothyroidism OR thyroid autoimmunity OR thyroperoxidase antibody (TPO

2019 Human Reproduction Update

18. Correction: Subclinical hypothyroidism. (PubMed)

Correction: Subclinical hypothyroidism. In Azim S, Nasr C, "Subclinical hypothyroidism: When to treat," Cleve Clin J Med 2019; 86(2):101-110, on page 103, in the section "Subclinical hypothyroidism can resolve or progress," the sentence "The rate of progression to overt hypothyroidism is estimated to be 33% to 35% over 10 to 20 years of follow-up" contained an error. The correct rate of progression is 33% to 55%. This error has been corrected online.

2019 Cleveland Clinic Journal of Medicine

19. Interventions for clinical and subclinical hypothyroidism pre-pregnancy and during pregnancy. (PubMed)

Interventions for clinical and subclinical hypothyroidism pre-pregnancy and during pregnancy. Over the last decade there has been enhanced awareness of the appreciable morbidity of thyroid dysfunction, particularly thyroid deficiency. Since treating clinical and subclinical hypothyroidism may reduce adverse obstetric outcomes, it is crucial to identify which interventions are safe and effective.To identify interventions used in the management of hypothyroidism and subclinical hypothyroidism pre (...) -pregnancy or during pregnancy and to ascertain the impact of these interventions on important maternal, fetal, neonatal and childhood outcomes.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 March 2013).Randomised controlled trials (RCTs) and quasi-randomised controlled trials that compared a pharmacological intervention for hypothyroidism and subclinical hypothyroidism pre-pregnancy or during pregnancy with another intervention or placebo.Two review authors assessed trial

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2013 Cochrane

20. Primary Care Corner with Geoffrey Modest MD: ?Thyroid meds for subclinical hypothyroidism in older adults

Primary Care Corner with Geoffrey Modest MD: ?Thyroid meds for subclinical hypothyroidism in older adults Primary Care Corner with Geoffrey Modest MD: ?Thyroid meds for subclinical hypothyroidism in older adults | BMJ EBM Spotlight by A assessed the effect of levothyroxine therapy in older adults with subclinical hypothyroidism, finding no clear benefit. Dr Geoffrey Modest 737 adults > 65 who had persistent subclinical hypothyroidism were randomized to levothyroxine 50 µg a day, or 25 µg (...) if their body weight were <50 kg or had coronary heart disease, with subsequent dose adjustment to achieve a TSH between 0.4 and 4.6 or placebo.( Subclinical hypothyroidism was defined as TSH of 4.60-19.99, with a free thyroxine level within the normal reference range. Primary outcomes were changes in the Hypothyroid Symptoms score and in the Tiredness score on the thyroid related quality-of-life questionnaire, at one year. Results: Mean TSH level decreased from 6.4 to 5.5 in the placebo group as compared

2017 Evidence-Based Medicine blog

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