Laboratory diagnosis: Subclinical hypothyroidism with increased TSH only Major risk: abnormal lipid metabolism and resulting atherosclerosis Development of clinical hypothyroidism Impact of subclinical hypothyroidism in pregnancy on offspring intelligence Treatment of subclinical hypothyroidism: thyroid hormone replacement therapy In 2004, the American Thyroid Association (ATA), the American Association of Clinical Endocrinologists (AACE) and the American Society of Endocrinology (TES) The following consensus was reached: TSH>10mIU/LØ L-T4 replacement therapy is advocated. The goals and methods of treatment are consistent with clinical hypothyroidism. TSH is between 4.0-10mIU/LØ L-T4 therapy is not advocated and TSH changes are monitored regularly. For TSH
4-10mIU/L and TPOAb positive patients, TSH changes should be closely monitored. This is because these patients are prone to develop clinical hypothyroidism.