WEDNESDAY, May 15, 2019 (Pharmacist's Briefing) -- Thyroid hormones are not recommended for adults with subclinical hypothyroidism (SCH), according to an article published online May 14 in The BMJ.
Geertruida E. Bekkering, Ph.D., from KU Leuven in Belgium, and colleagues conducted a systematic review to develop recommendations for thyroid hormone treatment among patients with SCH. Data were included from 21 trials with 2,192 participants.
The researchers found that thyroid hormones consistently demonstrated no clinically relevant benefits for quality of life or thyroid-related symptoms, including depressive symptoms, fatigue, and body mass index, for adults with SCH (moderate- to high-quality evidence). Thyroid hormones seem to have little or no effect on cardiovascular events or mortality (low-quality evidence); only one trial measured harms, with few events at two-year follow-up. Based on these findings, the guideline panel issued a strong recommendation against thyroid hormones in adults with SCH. The recommendation does not apply to women trying to get pregnant or patients with thyroid stimulating hormone levels >20 mIU/L and may not apply to young adults or patients with severe symptoms.
"Future research could explore whether there is an unidentified subgroup of patients who do benefit from treatment," the authors write. "No evidence of a potential subgroup or even a trend was observed in the current body of evidence, consistently across outcomes."