Information on hypothyroidism from Mainz
Not every hypothyroidism needs replacement therapy, emphasizes endocrinologist from Mainz
MAINZ. latent hypothyroidism, i.e. a deficiency in the body’s supply of hormones from the thyroid gland, can be treated with substitution therapy using the drug levothyroxine. However, experts are debating whether this form of therapy is always the right one. This is because if the TSH values, i.e. the values that indicate hypothyroidism or hyperthyroidism, are only slightly elevated and substitution of the hormone with levothyroxine is initiated, this can trigger so-called iatrogenic hypothyroidism. This is a functional disorder of the thyroid gland that is triggered by too much or too little thyroid hormone replacement. At the same time, hypothyroidism can develop without therapy, which has a favourable effect on cardiovascular diseases, explains endocrinologist Prof. Dr. med. Dr. h. c. Christian Wüster.
Thyroid gland: Mainz endocrinologist explains when latent hypothyroidism should be treated
Prof Wüster refers to a study by the Faculty of Medicine at the Technical University of Dresden, which only recommends treatment if the TSH value is greater than six mU/l and an antibody test against thyroid peroxidase is positive.
It is also necessary to confirm an increased TSH level in the blood through control tests under the same conditions. This is because the TSH level in the blood can be influenced by taking certain medications, for example. These include lithium or dopamine agonists. In addition, TSH levels are also slightly increased during puberty. If the ultrasound of the thyroid and examination are unremarkable, this situation is also not an indication for treatment with L-thyroxine.
Slightly increased TSH levels: Have the function of the thyroid gland checked by a specialist in Mainz
“A decision for or against therapy is always a decision made on an individual basis. Body weight and age also play a role,” explains Prof. Dr. med. Dr. h.c. Wüster. The TSH level increases with increasing waist circumference and body mass index. If the decision is made against therapy for slightly increased TSH levels, a check after six to twelve months is important. In any case, treatment should be initiated in patients with latent hypothyroidism and diagnosed Hashimoto’s thyroiditis if a positive antibody status can be demonstrated. It should be noted that different normal values apply during pregnancy, the endocrinologist points out.
