The New England Journal of Medicine published a study on April 3, 2017 about the use of levothyroxine to treat older adults with subclinical hypothyroidism (this article, and any other resources mentioned in this newsletter can be found in the "Quick Links" section). 

This study shed some new light on how we approach intermediate values of TSH. Previous guidance from various sources showed conflicting data but also conflicting interpretations of the same data. Symptom relief is the primary goal for patients. Symptoms that are suggestive of hypothyroidism including fatigue, constipation, scalp hair loss, and weight gain. 

The study concluded that Levothyroxine provided no apparent benefits in older persons with subclinical hypothyroidism.

The incidence of serious adverse events of special interest (atrial fibrillation, heart failure, fracture, or new diagnosis of osteoporosis) was similar in the two groups. There were no differences in muscle function or cognitive function.

An excellent review of this study in more patient-friendly terms was recently featured in the Health Section of the New York Times under the title "Could Be Thyroid, Could be Ennui. Either Way, the Drug Isn't Helping" - share it with your patients!