Now also known as mild hypothyroidism, subclinical hypothyroidism refers to hypothy-roidism that has not progressed very far, meaning that you have few or no symptoms. As you might guess, the most common cause of this is Hashimoto's thyroiditis. On a blood test, your free T4 (free thyroxine) readings would be normal or very close to normal, but your thyroid stimulating hormone (TSH) readings would be higher than normal.
Right now, there is much discussion in clinical circles about doing routine TSH testing in certain groups of people for subclinical hypothyroidism. This would include anyone with a family history of thyroid disease, women over forty, women after childbirth, and anyone over age sixty. Because the TSH test is simple and can be added to any blood laboratory package, it presents an opportunity to catch hypothyroidism before serious symptoms develop, and hence prevent it and all the symptoms discussed in this chapter. The following groups of people should be screened for subclinical hypothyroidism by having an annual TSH test:
• Anyone with a family history of thyroid disease
• Women planning pregnancy
• Pregnant women (very important!)
• Women who have just given birth (very important!)
• Women over forty
• Anyone over sixty
• Anyone with symptoms of depression (especially postpartum depression) or who has been diagnosed with depression (see Chapter 24)
• Anyone diagnosed with premature menopause, early menopause, or premature ovarian failure
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