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In fact, the so-called latent hypothyroidism occurs more often than you can imagine. With this condition, patients notice no manifestations of the disease. Moreover, the levels of T4 and T3 hormones might seem normal in this case. However, a good doctor can recognize this kind of hypothyroidism through symptoms and complaints. In addition, these patients have elevated TSH levels.

How common is latent hypothyroidism and how to treat it?

Mass surveys have shown that latent hypothyroidism is very widespread. Actually, among some population groups, the incidence is 15%. Moreover, the percentage reaches 25% in the elderly.

As with the usual diagnosis, the doctor will most likely recommend replacement therapy with Synthroid pills. Unfortunately, some patients do not tolerate such therapy well enough. On the other hand, without it, the condition will be much worse. In addition, if untreated, latent hypothyroidism increases the risk of developing aortic atherosclerosis and myocardial infarction.

Those patients who have goiter, chronic lymphocytic thyroiditis, hypercholesterolemia or decreased intelligence, as well as pregnant women, need substitution therapy even more than others. So, let us dwell a little more on the last point.

Latent hypothyroidism

How to organize a course of treatment in case of pregnancy?

Usually, with replacement therapy in adults, a specialist prescribes 100-150 mcg once a day. Better control your TSH every 4-6 weeks to assess the effectiveness of treatment.

However, during pregnancy with hypothyroidism, better increase the dose. This is due to the increase in serum thyroxine-binding globulin levels under the action of estrogens. As you can guess, this can happen not only in pregnant women.

By the way, due to an increase in the need for thyroid hormones, hypothyroidism may first appear exactly during pregnancy. In my experience, this usually occurs with latent chronic lymphocytic thyroiditis. Also, it concerns person living with a lack of iodine in water and food.

How lack of treatment during pregnancy can affect mother and child?

Unfortunately, severe hypothyroidism during pregnancy can lead to intrauterine fetal hypoxia, as well as mental and neurological disorders in babies. Also, recent studies have shown that even latent hypothyroidism in an expectant mother increases the risk of a moderate delay in psychomotor development in children.

Therefore, during pregnancy, seek for replacement therapy for any increase in TSH levels, even in the absence of other manifestations of hypothyroidism.

29.12.2020. Author: Antonio C. Bianco, MD, PhD.