Subclinical Hypothyroidism: Frequency,clinical presentations and treatment indications

Objective: to determine the frequency,modes of clinical presentation and indications for replacement therapy in a cohort of patients with subclinical hypothyroidism (sch). methods: this study was conducted at the endocrine and diabetes unit of jinnah postgraduate medical centre from september 2007 – october 2015. this was a retrospective chart analysis of prospectively collected data in which the medical records of 4448 patients who had presented to the endocrine clinic from 2007 to 2015 were reviewed. a total of 2760 (62.05%) patients were diagnosed with thyroid disorders,whereas 260 (9.42%) patients had sch. the sch patients were between the age of 12 to 70 years; tsh was >4miu/l with normal levels of ft3 and ft4. patients were enrolled using a predesigned structured proforma. those having chronic systemic diseases were excluded from this study. spss 13 was used to evaluate the data. results: female patients comprised 93.8% (244 patients) of those with sch,whereas only 6.2% (16 patients) were male. common presenting symptoms were,lethargy in 146 patients (56.2%); increase in weight in 102 patients (39.2%) and menstrual irregularities in 90 patients (34.6%). tsh level of < 10miu/l (4 - 10) was seen in 177 patients (68.1%) and 83 patients (31.9%) had tsh ≥ 10mu/l. thyroxine was given to 183 (70.4%) of these patients. common treatment indications were tsh of ≥ 10,which was seen in 83 patients (31.9%),subfertility in 32 patients (12.3%),troublesome symptoms suggestive of hypothyroidism in 31 patients (11.9%) and high titers of antibodies in 23 patients (8.8%). conclusion: sch is frequently seen in our population,with most patients complaining of lethargy. the most common treatment indications were a tsh ≥ 10miu/l,whereas troublesome symptoms of hypothyroidism and subfertility were the common treatment indications in patients who had a tsh of < 10miu/l. © 2017,professional medical publications. all rights reserved.