Hypothyroidism: To Screen or not to Screen
Journal of Thyroid Disorders & Therapy offers the most comprehensive and reliable information pertaining to the latest developments in the field. The Journal also believes in advancing new hypotheses and opinions by means of its high quality Reviews, Perspectives, and Commentaries. Thus, the content published in the journal is original and comprehensive.
Hypothyroidism is an entity that we all encounter in clinical practice, some more frequently than others. At times, this may be due to a referral where another physician has already checked a patient’s thyroid function and made a biochemical diagnosis. However, very often we are faced with the dilemma of whether we should check the thyroid function of a patient with subtle non-specfic complaints. Here, we try to rely on our clinical judgment and strive to appropriately utilize healthcare resources. Scenarios such as this give rise to a host of questions, most importantly, whom do we screen?
Subclinical hypothyroidism, on the other hand, seems to be more common. In the late 1970s, the Whickham survey of Northeast England revealed that 7.5% of women and 2.8% of men had subclinical hypothyroidism (TSH>6 mIU/L). Later, Vanderpump and Tunbridge reckoned that approximately 5% of different population cohorts have a TSH>6 mIU/L . In terms of ethnic variability, the National Health and Nutrition Examination Survey (NHANES III) noted that not only did serum TSH concentrations increase with age in both men and women; they were lower in African-Americans as opposed to their Caucasian counterparts, regardless of their antithyroid antibody titers . Interestingly, virtually all the clinical studies had done in this field document a higher prevalence rate of subclinical hypothyroidism in women and the elderly. Ðe Framingham Study itself demonstrated that 13.6% of women in the United States, older than 60 years, had a TSH>5 mIU/L.
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