Subclinical hypothyroidism in older people: should it be treated?

Unlike what the term suggests, 'subclinical hypothyroidism’ is a biochemical and not a clinical diagnosis. As stated in the current guideline on thyroid disorders issued by the Dutch College of General Practitioners (NHG), subclinical hypothyroidism rarely forms the correct explanation for a patient’s symptoms, and the guideline therefore recommends a reticent prescribing policy. The study described here indeed shows that levothyroxine supplementation cannot be expected to have any effect on the quality of life of persons with TSH levels up to 10 mU/L. Nevertheless, doctors might still consider a trial treatment for individual patients.

  1. Stott D.J. et al. Thyroid Hormone Therapy for Older Adults with Subclinical Hypothyreoidism. N Engl J Med 2017;  376:  2534-2544.
  2. Gezondheidsraad. Maat houden met medisch handelen. Den Haag; publicatienummer 2017/06.
  3. NHG-Standaard Schildklieraandoeningen, M 31. juli 2013.

*The literature refers to the Dutch text


  • Dr A.J.F.A. Kerst