Hypothyroidism

Lesson 4: Getting Your Diagnosis

A Word About Subclinical Hypothyroidism

Sometimes, you’ve gone through all of the diagnostics and you just come up short. You don’t have hypothyroidism. Well, at least not in the clinical sense. Millions of people have this condition, which is called subclinical hypothyroidism.

Subclinical hypothyroidism is difficult to diagnose. (Big surprise, right?) Anyway, there are three, basic criteria a patient should meet before they will be diagnosed with this condition. These are:

Of course, even this definition is contested. The first statement describes subclinical hypothyroidism as a symptomatic, meaning people with this condition have no symptoms. That’s not true! Many people with this condition do have symptoms. They are the same as the symptoms for hypothyroidism. Symptoms that are commonly found in those with subclinical hypothyroidism include fatigue, depression and cold intolerance.

It’s important to note also that the risk factors for subclinical hypothyroidism are the same as those for hypothyroidism. They include: female gender, age over 35, fertility issues and the like. (For a more complete list of the symptoms and risk factors of hypothyroidism, please refer back to lesson 3.)

As time goes on, the medical community is realizing that subclinical hypothyroidism usually becomes hypothyroidism. Currently, there is no hard and fast rule regarding treatment for this condition. Some doctors refuse to treat subclinical hypothyroidism. Others, only treat elderly patients with the condition because their incidence of becoming clinically hypothyroid without treatment is higher. There are other doctors (and I believe that number is growing) who will treat those with subclinical hypothyroidism if the patient:

• is pregnant,
• has a TSH over 10,
• exhibits symptoms of hypothyroidism,
• has had surgery for Graves’ Disease,
• and/or has a history of radiation therapy.

If a doctor decides to treat this condition with medication, the patient is generally given T4 in its synthetic form, Levothyroxine. T3 supplementation is not given for subclinical hypothyroidism as a general rule.

Some doctors treat the condition by monitoring the patient’s thyroid more often with blood tests and other diagnostics. However, the most common treatment for subclinical hypothyroidism is still none at all.

Is that wise?

Many in the medical community question this decision to not treat subclinical hypothyroidism. The fact remains that as many as 4% of men and 8% of women under the age of 60 and 8% of men and 15% of women over 60 are afflicted with this condition. Many of these people, especially in the over-60 age group, will develop hypothyroidism at some point.

Even if an individual does not develop hypothyroidism as a result of this condition, there are other potential risks to the patient who is subclinical hypothyroid and receives no treatment. These include increased incidences of:

I wish that I could say that the controversy surrounding subclinical hypothyroidism was atypical of the medical community’s difficulty in agreeing on treatments for thyroid conditions, but it’s not.

In the next few lessons, we’ll see what some of the different treatments are. We’ll delve into medications, alternative and holistic options as well as how diet and exercise can help the hypothyroid. Before we leave this current lesson, we’ve got one more section of text and the bibliography. In the next section, we’ll talk about specialists. Maybe you’ll need them; maybe you won’t, but, at least, you’ll know what they can do for you.

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