International Journal of Women's Health (Oct 2023)
Hypothyroidism in Adult Women: The Utility of Targeted vs Universal Thyroid Screening
Abstract
Neha P Godbole,1 Margaret Koester,1 Erin N Marcus2 1University of Miami Miller School of Medicine, Miami, FL, USA; 2Department of Internal Medicine, University of Miami Miller School of Medicine, Miami, FL, USACorrespondence: Neha P Godbole, University of Miami Miller School of Medicine, 1120 NW 14th St, Miami, FL, 33136, USA, Tel +1 305 243 9678, Email [email protected]: Hypothyroidism is a common disease that is more prevalent in female populations. The purpose of this paper is to discuss the evidence, risks, and benefits of screening asymptomatic women for hypothyroidism. There is lack of evidence to support clinical management of asymptomatic individuals with an elevated TSH and normal serum thyroxine levels. Patients with subclinical hypothyroidism, especially the elderly, are at risk of overtreatment. Given these considerations, the majority of US and UK professional organizations do not support universal screening. Many do offer caveats for special groups, including pregnant people, who may need screening if there are clinical symptoms or family history of autoimmune disease. In conclusion, targeted screening may be best recommended based on risk factors, symptoms, and clinical suspicion, rather than at a universal level.Keywords: asymptomatic, subclinical, overt, universal
