Subclinical hypothyroidism: summary of evidence in 2014

Swiss Med Wkly. 2014 Dec 23;144:w14058. doi: 10.4414/smw.2014.14058. eCollection 2014.


Subclinical hypothyroidism, which is defined as elevated thyroid-stimulating hormone (TSH) levels with free thyroxine concentrations within the reference range, is a common disorder that increases with age and affects up to 18% of the elderly, with a higher prevalence in women compared to men. Prospective data have shown an increased risk of coronary heart disease events, heart failure, and cardiovascular mortality among affected adults. Conflicting results have been found on the association between subclinical hypothyroidism and cognitive impairment, depression and the risk of fractures. Management strategies including screening and treatment of subclinical hypothyroidism are still controversial, while the ongoing European randomised controlled trial "TRUST" targets to solve these uncertainties. This narrative review aims to assess current evidence on the clinical aspects, as well as screening and treatment recommendations in adults with subclinical hypothyroidism.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Asymptomatic Diseases / epidemiology
  • Asymptomatic Diseases / therapy*
  • Cardiovascular Diseases / epidemiology*
  • Female
  • Humans
  • Hypothyroidism / blood
  • Hypothyroidism / diagnosis*
  • Hypothyroidism / drug therapy*
  • Hypothyroidism / epidemiology
  • Male
  • Mental Disorders / epidemiology
  • Muscular Diseases / epidemiology
  • Thyrotropin / blood
  • Thyroxine / blood


  • Thyrotropin
  • Thyroxine