Subclinical hypothyroidism guidelines ‘not supported by evidence’, critics say

A spat has erupted over new practice guidelines that advise against prescribing thyroid hormone replacement therapy for adults with subclinical hypothyroidism.
The British Thyroid Association and the Society for Endocrinology in the UK have criticised the recommendations, published in the BMJ last month, citing concerns patients may miss out on crucial early treatment and therefore progress to hypothyroidism.
The guidelines recommend against prescribing thyroid hormone therapy for patients with only slightly elevated TSH levels (4-10mIU/L) and free thyroxine levels within the normal range.
This does not apply to pregnant women, those trying to conceive, or those with TSH levels exceeding 20mIU/L, they say.