ABSTRACT
Objective: To determine the frequency, modes of clinical presentation and indications for replacement therapy in a cohort of patients with subclinical hypothyroidism [SCH]
Methods: This study was conducted at the Endocrine and Diabetes Unit of Jinnah Postgraduate Medical Centre from September 2007 - October 2015. This was a retrospective chart analysis of prospectively collected data in which the medical records of 4448 patients who had presented to the Endocrine Clinic from 2007 to 2015 were reviewed. A total of 2760 [62.05%] patients were diagnosed with thyroid disorders, whereas 260 [9.42%] patients had SCH. The SCH patients were between the age of 12 to 70 years; TSH was >4mlU/l with normal levels of FT3 and FT4. Patients were enrolled using a predesigned structured proforma. Those having chronic systemic diseases were excluded from this study. SPSS 13 was used to evaluate the data
Results: Female patients comprised 93.8% [244 patients] of those with SCH, whereas only 6.2% [16 patients] were male. Common presenting symptoms were, lethargy in 146 patients [56.2%]; increase in weight in 102 patients [39.2%] and menstrual irregularities in 90 patients [34.6%]
TSH level of < 10mlU/l [4-10] was seen in 177 patients [68.1%] and 83 patients [31.9%] had TSH > 10mU/l. Thyroxine was given to 183 [70.4%] of these patients. Common treatment indications were TSH of > 10, which was seen in 83 patients [31.9%], subfertility in 32 patients [12.3%], troublesome symptoms suggestive of hypothyroidism in 31 patients [11.9%] and high titers of antibodies in 23 patients [8.8%]
Conclusion: SCH is frequently seen in our population, with most patients complaining of lethargy. The most common treatment indications were a TSH > 10mlU/l, whereas troublesome symptoms of hypothyroidism and subfertility were the common treatment indications in patients who had a TSH of < 10mlU/l