Subclinical hypothyroidism: new trials, old caveats.

Détails

ID Serval
serval:BIB_368C50B10967
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Subclinical hypothyroidism: new trials, old caveats.
Périodique
Hormones
Auteur(s)
Lamine F., De Giorgi S., Marino L., Michalaki M., Sykiotis G.P.
ISSN
2520-8721 (Electronic)
ISSN-L
1109-3099
Statut éditorial
Publié
Date de publication
06/2018
Peer-reviewed
Oui
Volume
17
Numéro
2
Pages
231-236
Langue
anglais
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Résumé
The indications for levothyroxine replacement therapy for subclinical hypothyroidism (SH) remain a subject of debate, especially when prescribed for older adults. The results of the recent TRUST trial indicate that levothyroxine does not improve clinical symptom scores among elderly patients with SH. While there is much concern regarding the dilemma of introducing or withholding levothyroxine, less attention may be paid to the differential diagnosis of an elevated TSH level, which is the prerequisite for diagnosing SH. Herein, we review these issues facing endocrinologists and internists/generalists either in practice or in training. When a patient presents abnormal thyroid test results compatible with SH, a series of issues need to be addressed before the implementation of replacement therapy is considered: first, an isolated TSH elevation not linked to a primary thyroid pathology should be excluded; second, the persistent nature of the patient's TSH elevation and SH profile should be verified; third, SH symptoms and potential complications relevant for the specific patient should be documented; fourth, expectations from levothyroxine substitution therapy for SH in the specific patient should be clarified. Only then can the decision be made whether levothyroxine substitution should be introduced or not.
Mots-clé
Hormone Replacement Therapy/standards, Humans, Hypothyroidism/diagnosis, Hypothyroidism/drug therapy, Practice Guidelines as Topic, Thyroxine/therapeutic use, Guidelines, Personalized medicine, Subclinical hypothyroidism, TRUST
Pubmed
Web of science
Open Access
Oui
Création de la notice
15/06/2018 17:58
Dernière modification de la notice
20/08/2019 14:24
Données d'usage