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When and how is subclinical hypothyroidism treated?

Q: I am a patient of hypothyroidism. My TSH is 6.06 and I have started taking Thyronorm 25 mcg. I have also gone through antibodies test, which has come positive. My wife too has been diagnosed with hypothyroidism and her TSH is 4.3. She is also on Thyronorm 37 mcg. When she was first diagnosed, her TSH was 5.8 and was put on Thyronorm 25 mcg. After 4 weeks her TSH was 2.8, then she kept on taking the same dose and the TSH level after one month increased to 3.7. The dose was also increased to 31 mcg but after fifteen days it came 4.3 and she is taking Thyronorm 37 mcg now. My question what precautions should we take for our children? We have three kids - the eldest daughter is 8 years old, the younger daughter is 3 years old and our youngest son is 1 year 8 months old and is still breast fed. What sort of a diet should we take? We are drinking water purified by Reverse Osmosis system, is it fine or it kills the iodine of water? Is it safe?

A:This condition is called as Subclinical hypothyroidism. In this disease TSH is slightly high but T4 levels are normal and patients usually do not have much symptoms. Most of the patients do not need treatment unless they have following:

  • High cholesterol levels
  • Big thyroid gland (goitre) with positive antibodies
  • Young women having menstrual abnormalities, infertility
  • Progressive rise in TSH level over a time associated with rising Antibody titers In your and your wife's case it is important to know what was the indication to start treatment because subclinical hypothyroidism is relatively benign condition. You may pass on the information why the treatment was started and why the TSH was done in first place for clarifying whether you need to continue treatment or not.

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