Sub-clinical hypothyroidism: to treat or not to treat?

While clear in adults, younger patients need case-by-case decisions, specialist says

Adults with subclinical hypothyroidism do not routinely need thyroid hormone therapy, according to the largest review of evidence to date.

Although thyroid hormone therapy lowered average TSH levels to within the normal range, it did not improve thyroid symptoms, based on findings from a review of pooled data from 21 randomised controlled trials covering 2200 patients.

Patients received therapy for 3-18 months and were deemed to have subclinical hypothyroidism if their TSH level was above the reference range but their free thyroxine level was within range.