Actualización del manejo integral del hipotiroidismo subclínico

Abstract

Hypothyroidism is a pathology characterized by high levels of the stimulating hormone called thyrotropin (TSH), on several occasions it manifests itself with mild symptoms, it precedes the subclinical term since, unlike the underlying disease, the hormonal levels of tetraiodothyronine and triiodothyronine are They are normal. Currently the decision of the correct management of the disease is a subject of debate, since an inadequate management of it can lead the patient to develop primary hypothyroidism, the frequency of thyroid diseases at present are causes of morbidity, mortality and disability at the worldwide, taking into consideration that hypothyroidism is the twenty-third most common diagnosis evaluated in medical consultation. Objective: To analyze the updated available literature on subclinical hypothyroidism, clinical manifestations, identification and comprehensive management. Method: Systematized Bibliographic Review of literature based on the selection of scientific articles from recent years based on the PRISMA method. Results: There is evidence of a clear clinical improvement in patients with T4 hormonal treatment, as long as the patient presents clear symptoms of the pathology, the benefit during pregnancy and in patients with comorbidities is significantly favourable, otherwise the analysis of the risks of the therapy is still in controversy. Conclusions: The treatment of subclinical hypothyroidism is totally individualized, pharmacological intake by hormone replacement with levothyroxine has shown significant benefits in symptomatic patients, the riskbenefit ratio will depend on the causes of said pathology according to the characteristics of the patient such as; race, sex and age.