Monitoring untreated subclinical hypothyroidism after stopping treatment

Monitoring untreated subclinical hypothyroidism and monitoring after stopping treatment

Adults

For adults with untreated subclinical hypothyroidism or adults who have stopped levothyroxine treatment for subclinical hypothyroidism, consider measuring TSH and FT4:

• once a year if they have features suggesting underlying thyroid disease, such as previous thyroid surgery or raised levels of thyroid autoantibodies,
• or once every 2 to 3 years if they have no features suggesting underlying thyroid disease.

Children and young people

Consider measuring TSH and FT4 for children aged 2 years and over and young people with untreated subclinical hypothyroidism and a TSH lower than 10 mlU/ litre:

• every 3 to 6 months if they have features suggesting underlying thyroid disease, such as thyroid dysgenesis (an underdeveloped thyroid gland) or raised levels of thyroid autoantibodies, or
• every 6 to 12 months if they have no features suggesting underlying thyroid disease

Consider measuring TSH and FT4 every 1 to 3 months for children aged between 28 days and 2 years with untreated subclinical hypothyroidism.

Consider stopping TSH and FT4 measurement in children and young people if the TSH level has stabilised (2 similar measurements within the reference range 3 to 6 months apart) and there are no features suggesting underlying thyroid disease.

Reference:

• NICE (November 2019). Thyroid disease: assessment and management