TSH Levels in Subclinical Hypothyroidism in the 97.5th Percentile of the Population
Autor: | Hector Martínez Ruíz, Gabriel Mayoral-Andrade, Alma Dolores Pérez Santiago, Margarito Martínez Cruz, Edgar Zenteno, Ruth Martínez-Cruz, Laura Pérez-Campos Mayoral, Eduardo Pérez-Campos, María Teresa Hernández-Huerta, Eduardo Pérez-Campos Mayoral |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Pediatrics
medicine.medical_specialty Percentile endocrine system endocrine system diseases Endocrinology Diabetes and Metabolism Population 030209 endocrinology & metabolism Review Article 030204 cardiovascular system & hematology Diseases of the endocrine glands. Clinical endocrinology 03 medical and health sciences 0302 clinical medicine Endocrinology medicine Prospective cohort study education Subclinical infection education.field_of_study Endocrine and Autonomic Systems business.industry Thyroid RC648-665 Anti-thyroid autoantibodies Natural history medicine.anatomical_structure Cutoff point business hormones hormone substitutes and hormone antagonists |
Zdroj: | International Journal of Endocrinology, Vol 2020 (2020) International Journal of Endocrinology |
ISSN: | 1687-8345 1687-8337 |
Popis: | The debate regarding the cutoff point in the treatment of patients with subclinical hypothyroidism (Shypo) is ongoing. Generally, two different groups are identified for treatment by levels of 10 and 20 mIU/L. Nevertheless, the question remains, “what cutoff point should be chosen?” We have written a selective nonsystematic review focused on the 97.5 percentile reference value reported in healthy subjects in a number of countries and observed important disparities, which partly show the challenge of identifying a single cutoff point for those patients needing medication. We identified studies of TSH on the natural history of subclinical hypothyroidism from population-based prospective cohort studies, which follow up patients for several years. The evolution of TSH levels in these patients is variable. Some cases of TSH may return to lower levels at different stages over the years, but others may not, possibly even developing into overt thyroid failure, also variable. We analyzed factors that may explain the normalization of serum TSH levels. In addition, we found that thorough population-based prospective cohort studies following up on TSH levels, thyroid antibodies, and ultrasonography are important in decisions made in the treatment of patients. However, the 97.5 percentile reference value varies in different countries; therefore, an international cutoff point for subclinical hypothyroidism cannot be recommended. |
Databáze: | OpenAIRE |
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