Subclinical hypothyroidism: the case for treatment

The issue regarding patients with subclinical hypothyroidism and whether they should be treated has been debated for many years in clinical endocrinology. The main concerns are the cardiovascular and hyperlipidaemic risks associated with this condition, in addition to the risk that these patients have of developing neuropyschiatric features while progressing to overt hypothyroidism. Early detection, potential benefits of longterm treatment and patient satisfaction associated with the alleviation of symptoms are all important aspects of therapy. Here, we detail many studies, including randomized control trials and case–control studies, that demonstrate the benefits of thyroxine replacement therapy on cognition, symptoms such as dry skin and low mood (among others), the cardiovascular system and plasma lipids. We conclude that it is better to treat this not uncommon condition by showing the benefits of early replacement therapy in selected groups. [Copyright &y& Elsevier]