Subclinical hypothyroidism (a mildly elevated TSH with normal T4) is frequently treated with levothyroxine. The evidence for this in many patients is weak. Whether the original indication was clinically justified is a question very few patients have ever been invited to ask.
Full page coming soonThe clinical distinction between a TSH that warrants treatment and one that doesn't, and why many patients on levothyroxine fall into a grey area.
Illness, stress, pregnancy, and certain medications can transiently raise TSH. A single elevated reading may not represent true hypothyroidism.
What the trials actually show about symptom benefit, particularly in older patients where the evidence is weakest.
Gradual dose reduction with TSH and T4 monitoring at each stage. The taper is slow, measured, and fully reversible.
What to expect, what is normal variation, and what would indicate the thyroid is genuinely not compensating.
The circumstances in which continuing levothyroxine is clearly the right clinical decision: overt hypothyroidism, post-thyroidectomy, post-radioiodine.
In the meantime, if you have questions before this page is complete, contact the practice directly, or book a consultation online. Every enquiry is reviewed personally by Dr Dan Reardon.