[Subclinical hypothyroidism: a diagnostic and therapeutic approach in primary care].

OBJECTIVE: A diagnostic and therapeutic assessment of 7 cases of subclinical Hypothyroidism (SH).

DESIGN: Retrospective clinical observations.

SETTING: Primary Care. Luis Vives Health Centre in Alcalá de Henares.

PATIENTS AND OTHER PARTICIPANTS: Seven women between 20 and 66 years old with a diagnosis of SH were studied in the clinic, in collaboration with the area endocrinology service.

MEASUREMENTS AND MAIN RESULTS: High levels of TSH and normal T4L levels were found in the 7 cases. Levels of antithyroid antibodies and a morphological study of the thyroid gland were also requested. Treatment with L-thyroxin was initiated in 3 cases. A periodic analytical control was decided for the remaining 4.

CONCLUSIONS: The Primary Care professional can contribute to the diagnosis of SH and to the improvement of its therapeutic control. There are still many unresolved questions about SH, such as these patients' evolution. Knowing more about this could help more concretely to set up screening and long-term treatment, in order to prevent possible evolution of clinical hypothyroidism. Positive microsomal antibodies (> 1/1600), the presence of goitre, especially accompanying Hashimoto's thyroiditis, isolated levels of TSH > 14 mU/l or TSH > 10 mU/l with a titer of positive antithyroid antibodies, can be considered the most reliable indicators for initiating replacement treatment.