Guidance in subclinical hyperthyroidism and subclinical hypothyroidism: are we making progress?
WM Wiersinga, European Thyroid Journal 2015, Vol. 4, No. 3
Although the evidence of associations between SHyper or SHypo and adverse health outcomes has become much stronger in the last decade, evidence is lacking that restoration of the euthyroid state reverses the risk of adverse health outcomes. There are no long-term randomized clinical trials demonstrating that treatment will do more good than harm. Against this background, one may wonder whether the grades of evidence attached to some of the recommendations are not overrated. Nevertheless, the guidelines could be very helpful in making treatment decisions.
In this editorial, however, W.M. Wiersinga would like to explore the question if we are really making progress in thoughts about SHyper and SHypo. In other words, which topics have not been addressed by the present guidelines? Are there less prominent but still clinically relevant issues?