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kamaikim 09-09-2012 03:07 PM

Subclinical hypothyroid
Hello everyone. Obviously a new person here, but this seemed like it might be the place to get some answers.

I went to my doctor recently because I suspected I might be hypothyroid. It runs in my mother's side of the family (my mom has it, uncle, one of my aunts, and my late grandfather). I've been feeling more off than normal (I suffer from depression, allergies, headaches...someetimes I feel like a hyperchondriac). I've been extremely lethargic, my appetite is here and there even when I felt hungry I couldn't eat, etc. So I went to the doctor and her ordered some tests.

He called me on Friday and said the results show that I am subclinical hypothyroid. I was so amazed that something actually IS wrong with me, and I was at work, that I couldn't ask many questions. He put me on 50 mcg Synthroid and I'm supposed to go back in about 2 months.

So my question is, what the heck is the difference between subclinical hypothyroid and just hypothyroid? I tried researching online and the answers I found were difficult to understand. Is this something that goes away? Will I be on medication forever? What does the "subclinical" distinction actually indicate?

I'm the kind of person who needs to know everything about every little thing that's wrong with me, so any info would be greatly appreciated! BTW, my test results are at the bottom if it helps any.


TSH 7.62 mIU/L
Reference Range > or = 20 Years 0.40-4.50

midwest1 09-09-2012 04:12 PM

Re: Subclinical hypothyroid
Hi there. Welcome to the board from another Missourian. (St. Louis)

While I'm very happy your doctor prescribed Synthroid for you, what he doesn't seem to know is frankly disturbing.

His use of "subclinical" is truly wrong. The meaning of the word in The American Heritage medical dictionary is "Not manifesting characteristic clinical symptoms". True 'subclinical' disease happens where lab values are abnormal but there are no symptoms. Quite clearly, you [u]have[/u] multiple characteristic symptoms. Plus, your TSH is well above the lab's reference range, which is another sign that there is nothing "subclinical" about your condition. You are definitely hypothyroid, no doubt about that. As long as he gave you that prescription, it might be okay to tolerate him being wrong about the "subclinical" issue... But it doesn't bode well for you that he'll ultimately treat you optimally. It's possible he will want to deny you a therapeutic dose of Synthroid that will eliminate your hypoT symptoms. It's possible he will get your TSH to a place where [b]he[/b] is comfortable, but [b]you[/b] aren't. It's possible that you will need a T3 supplement in addition to your Synthroid, and he may not ever be willing to prescribe it. Just be aware that undertreatment is common to this condition, but that you won't have to tolerate it if you educate yourself enough to know what to demand.

The autoimmune disease known as Hashimoto's thyroiditis is the most common cause of hypothyroidism in the US. It's caused by elevated titers of antibodies which destroy the thyroid gland. Once the gland is damaged enough to stop producing adequate thyroid hormone, it becomes a permanent condition that can only be remedied with prescription thyroid hormone replacement. Autoimmune disease is stronly familia, so it seems this is what you have also. (You could ask for anti-TPO and anti-Tg antibody tests if you're curious, but it doesn't change the treatment and so, is not strictly necessary.) HypoT, for those reasons, is almost certainly a lifelong deal.

For help in learning the basics, read our "Thyroid Information" sticky thread, or get a copy of [i]Thyroid for Dummies[/i] by Dr. Alan Rubin. It's available at most public libraries or isn't too expensive to buy for yourself.

KitsMn 09-10-2012 07:07 AM

Re: Subclinical hypothyroid
subclinical is when your tsh is above the lab your case above 4.50 and less than 10. Once your tsh gets over 10 (for whatever reason), they no longer consider you subclinical. I don't know what their reasoning is. I've heard some doctors won't treat if it's under 10 but I think that is changing.

kamaikim 09-10-2012 01:39 PM

Re: Subclinical hypothyroid
Thanks for the replies. As far as being concerned about my doctor, I suppose I'll just have to wait and see how my treatment progresses, if at all. He's been my PCP for probably about 15 years so I feel a bit awkward nay-saying his diagnoses.

But anyway, this information has been extremely helpful. Just googling "hypothyroid" overloaded my brain with information, so it's nice to narrow it down to the things I need to know.

Bran'sNana 09-10-2012 05:02 PM

Re: Subclinical hypothyroid
Very good advice, educate yourself, this is the best way to get the right treatment. Most docs don't seem to know much about thyroid disease. You have to be proactive. see if you can get him to run the FT3. It might help to see where this is too. I'm guessing that's low too.

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