• Jeannine Schübel, Joachim Feldkamp, Antje Bergmann, Wolfgang Drossard, and Karen Voigt.
• Technische Universität Dresden, Faculty of Medicine Carl Gustav Carus, Department of General Practice/MK3, Dresden, Germany; Municipal Hospital Bielefeld, Department for Endocrinology and Diabetes, Bielefeld, Germany; GesundheitsZentrum Kelkheim.
• Dtsch Arztebl Int. 2017 Jun 23; 114 (25): 430438430-438.

BackgroundThe prevalence of latent/subclinical hypothyroidism is between 3% and 10%, according to epidemiologic studies that have been carried out in the USA, the United Kingdom, and Denmark. As persons with latent hypo - thyroidism are often asymptomatic, the diagnosis is often made incidentally in routine laboratory testing.MethodsThis review is based on a selective search in PubMed for publications on the diagnosis and treatment of latent hypothyroidism. All pertinent articles and guidelines published from 1 January 2000 to 31 July 2016 were included.ResultsThe diagnosis of latent hypothyroidism is generally assigned after repeated measurement of a TSH concentration above 4.0 mU/L in a person whose fT4 concentration is in the normal range. The most common cause is autoimmune thyroiditis, which can be detected by a test for autoantibodies. L-thyroxin supplementation is a controversial matter: its purpose is to prevent the development of overt hypothyroidism, but there is a danger of overtreatment, which increases the risk of fracture. To date, no benefit of L-thyroxin supplementation has been demonstrated with respect to morbidity and mortality, health-related quality of life, mental health, cognitive function, or reduction of overweight. There is, however, evidence of a beneficial effect on cardiac function in women, and on the vascular system. At present, treatment is generally considered indicated only if the TSH level exceeds 10.0 mU/L.ConclusionLimited data are available on the relevant clinical endpoints and undesired side effects of supplementation therapy. Physicians should advise patients about the indications for such treatment on an individual basis after due consideration of the risks and benefits.

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