Subclinical hypothyroidism can be referred to as a near-condition or an early stage of hypothyroidism. The following article throws light on some of the basic aspects of this disease of the thyroid gland.
The term ‘subclinical’ is defined as ‘a stage of a disease where the symptoms have not yet occurred.’ True to its name, subclinical hypothyroidism is a stage wherein, the patient, although has increased Thyrotropin-Stimulating Hormone (TSH) levels, still has his thyroxine (T4) levels at a normal stage. More often than not, this condition progresses into a full-fledged form of hypothyroidism (a condition wherein the thyroid hormone is unable to produce certain hormones important for different bodily process).
Although in some patients, it has shown improvements in the form of either getting resolved or being unchanged. A person may get diagnosed with this subclinical condition after a medical professional examines his medical history and physical examination. Lab tests are often required to make a confirmation of the diagnosis. People who are considered vulnerable to develop this condition, as observed by most doctors, are women over 60 years of age (about 2 out of 10). Also, out of 10 people with this condition, 2-5 of them eventually develop hypothyroidism every year.
Symptoms
In most cases, this condition do not show any symptoms thus, it is regarded as subclinical. However, in some cases, the patient may exhibit certain symptoms which can be regarded as the mild form of hypothyroidism symptoms. These may include:
- Dry skin
- Easy fatigability; more than usual, and sometimes without any exertion
- The affected person may develop increased sensitivity towards cold climate
- Abnormal weight gain
- The patient may also exhibit symptoms of depression
- Memory problems
These symptoms may or may not be present in the affected person, but there are some which do indicate the disease. These, as already cited above, include elevated levels of TSH, and normal thyroxine levels. For a person to get diagnosed by hypothyroidism, his TSH levels must be more than normal, and his thyroxine levels, lower than normal.
Causes
Factors behind the development of this condition, as what doctors have determined, are the same ones which are responsible for causing hypothyroidism.
- The most common cause of subclinical hypothyroidism and hypothyroidism itself is an autoimmune disorder such as Hashimoto’s disease. Here, the immune system produces antibodies which, for unknown reasons, attack healthy thyroid tissues thus, affecting the gland’s ability to produce hormones.
- Another cause could be a treatment to manage hyperthyroidism (here, the thyroid gland produces hormones more than what is required). Usually, the treatment involves the use of radioactive iodine, or medications that may inhibit the thyroid gland from producing too much hormones. So one side effect of such treatment could be subclinical hypothyroidism.
- Other causes may include cancer treatment such as radioactive therapy, surgery of the thyroid gland, and use of medications such as lithium and amiodarone.
Treatment
As of now, current research and findings do not validate the treatment of subclinical hypothyroidism in children or adults, for every case. According to some medical bodies, people who have this condition, but have a serum TSH levels of 4.5 to 10 mU/L, are not considered as suitable candidates to undergo any sort of treatment whatsoever. However, patients who can be considered so, are ones whose test results show a TSH reading of greater than 10 mU/L.
Besides the greater magnitude of the TSH levels, if the same remains high for a long duration, then it is most likely that the subclinical condition would progress into an overt hypothyroidism. Thus, this increases the potential benefit of any treatment that might be recommended. So primarily, the duration of the symptoms may give a clue whether the condition has the potential to turn into a full-blown hypothyroidism. And depending on how high the possibility is, treatment measures may be recommended.
To conclude, merely getting diagnosed with subclinical hypothyroidism does not warrant the person to seek and receive treatment. However, regular follow ups with the doctor, and weighing out the benefits of the treatment with the cost that would be incurred in the treatment, may help the patient and the doctor get to a decision of commencing the same.
