Treating Subclinical Hypothyroidism Yields No Benefit in Quality of Life or Thyroid-Related Symptoms

The benefits of treating subclinical hypothyroidism (defined as elevated thyrotropin level and normal free thyroxine level) are unclear, and recent large trials have shown no value (e.g., NEJM JW Gen Med May 15 2017 and N Engl J Med 2017; 376:2534). This new meta-analysis included 21 randomized trials (2192 total patients) in which patients were treated for at least 1 month, with follow-up for at least 3 months. Various outcomes were assessed, including general quality of life, fatigue, depression, cognitive function, systolic blood pressure, and body-mass index.

Mean thyrotropin levels ranged from 4.4 to 12.8 mIU/L at baseline and from 0.5 to 3.7 mIU/L at the end of follow-up. Duration of therapy ranged from 3 to 18 months. No differences w…