The "Subclinical" Thyroid Dilemma! We often see this report: High TSH, but Normal T3 & T4. Diagnosis: Subclinical Hypothyroidism. The big question from the patient (or relative) is always: "Doctor, do I need medicine?" Here is the Evidence-Based Rule: Generally, treatment with Levothyroxine is initiated ONLY if TSH > 10 mIU/L. For TSH between 4.5 - 10, we usually monitor, unless the patient is: Pregnant or planning pregnancy 🤰 Symptomatic (fatigue, goiter) TPO Antibody positive Interpreting lab
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