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Developing a sensitive and accurate assay for thyroid-stimulating hormone (TSH) improved diagnosis of thyroid diseases but also created some dilemmas. For example, “subclinical hypothyroidism” (i.e., elevated TSH levels and normal free thyroxine levels) is found in as many as 18% of elders (age, ≥65), particularly in older women. In only a few small randomized trials have researchers examined whether treatment to normalize TSH levels is beneficial, and the results have been inconclusive.
A group from the U.K. conducted a randomized trial that involved 737 older patients (age, ≥65) with laboratory evidence of untreated subclinical hypothyroidism in the previous 3 years (mean TSH level, 6.4 mIU/L). Patients received either supplemental levothy…