Subclinical hypothyroidism in adults. treat or monitor? current evidence, controversies and recommendations
DOI:
https://doi.org/10.29076/issn.2528-7737vol19iss52.2026pp13-23pKeywords:
adult, dyslipidemia, levothyroxine, cardiovascular risk, thyrotropinAbstract
Subclinical hypothyroidism continues to generate therapeutic uncertainty due to the discrepancy between biochemical alterations and clinical expression observed in numerous adult patients. Given the persistence of the debate about starting hormone treatment or maintaining periodic surveillance, the scientific evidence related to the effects of levothyroxine in different clinical contexts is critically examined. Through a narrative and critical review, research published in international biomedical databases was integrated, prioritizing clinical trials, observational studies and comparative analyses focused on symptoms, metabolic profile, cardiovascular risk and progression to overt hypothyroidism. The results show heterogeneous benefits, with greater therapeutic utility in subjects with elevated concentrations of thyroid-stimulating hormone (TSH), antithyroid antibody positivity and cardiovascular risk factors, while in older adults and paucisymptomatic patients a limited clinical impact predominates. Therapeutic conduct requires individualized assessment, avoiding both undertreatment and overtreatment
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Copyright (c) 2026 Marcela Madeline Gálvez Peralta, María Belén Vanegas Yaguana, Winston Andrés Zavala Alarcón , Elizabeth Cayetana Menéndez Zambrano, Alexi María Arroba Parraga
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