Subclinical Hypothyroidism

Did you know that close to 200 million of the world’s total population struggles with some kind of thyroid disorder? Among them, subclinical hypothyroidism is a leading complication that affects a few million people worldwide.

So it is important to understand what it is, and how it differs from the standard case of Hypothyroidism that we know about. In most cases, subclinical hypothyroidism is marked as an “early form” of hypothyroidism, more like a precursor. This happens when the pituitary gland secretes a slightly higher amount of the thyroid-stimulating hormone.

This article will further look into everything you need to know about subclinical hypothyroidism, its impacts on the body, and available treatment options.

What is Subclinical Hypothyroidism?

Subclinical hypothyroidism is a medical condition where the patient has elevated levels of the thyroid stimulating hormone (TSH) but normal levels of the thyroid hormones T3 (Triiodothyronine) and T4 (thyroxine).

In such cases, the patient isn’t classified as having hypothyroidism but is at risk of developing the same if the condition is regulated and managed.

Overall, you have subclinical hypothyroidism if you are at risk of developing overt hypothyroidism in the future due to elevated TSH levels in the body. This has similar symptoms to hypothyroidism, including affected metabolism, poor energy levels, etc.

Who is at Risk of Developing Subclinical Hypothyroidism?

Multiple factors can lead to the development of subclinical hypothyroidism in the patient. More on that will be discussed later.

However, what are some common risk factors associated with this condition? Let us get those straightened out:

Gender Studies have confirmed that women are at higher risk of developing subclinical hypothyroidism than men.

Age – The TSH levels tend to remain at the higher end as we age. This is why older people are often at risk of developing subclinical hypothyroidism.

Iodine intake – Iodine is a trace mineral necessary for the proper functioning of the thyroid gland. However, excess iodine intake can elevate the risks of developing subclinical hypothyroidism.

Once you know the risk factors, tallying the list of causes becomes a lot more seamless and easier.

What are the Causes of Subclinical Hypothyroidism?

Before we discuss the subclinical hypothyroidism causes, let us understand a bit more about the thyroid stimulating hormone (TSH).

Secreted from the pituitary gland, TSH is the hormone responsible for triggering the release of the thyroid hormones – T3 and T4.

That said, some of the potential causes of subclinical hypothyroidism include:

  • Family history of thyroid disorders or other autoimmune disorders.
  • Trauma or injury to the thyroid gland.
  • Undergoing radioactive iodine therapy for hyperthyroidism.
  • Side effects from medications containing iodine or lithium.
  • Thyroid inflammation.

Overall, identifying the root cause is crucial to then align the necessary route of subclinical hypothyroidism treatment for the patient.

What are the Symptoms of Subclinical Hypothyroidism?

Since the condition of subclinical hypothyroidism is like the precursor to overt hypothyroidism, many patients experience some of the mild symptoms of hypothyroidism also.

In most cases, there are no symptoms involved.

Following are a few subclinical hypothyroidism symptoms worth considering:

  • Unexplained weight gain
  • Lacking energy or fatigue
  • Constipation
  • Depression
  • Sensitivity to colder temperatures
  • The dry and coarse texture of the skin and hair
  • High blood pressure
  • Heavy menstrual bleeding
  • Goiter
  • Hair loss, etc.

These symptoms are non-specific, which means that they aren’t standard, and every patient diagnosed with subclinical hypothyroidism might not have these symptoms.

What is the Mode of Diagnosis of Subclinical Hypothyroidism?

If you are experiencing symptoms of mild hypothyroidism that weren’t there before, being on high alert is common. Everyone wants a comprehensive understanding of what’s wrong with their body instead of living in the dark.

Hence, a comprehensive bout of diagnosis is mandatory. Proper diagnosis ensures that the patient can get the required treatment to manage their symptoms and prevent things from worsening.

For diagnosing subclinical hypothyroidism, the doctor will typically prescribe the thyroid function blood test, which includes measuring the levels of TSH, T3, and T4 in the blood. Unless you are pregnant, here’s how you can interpret the results:

  • Normal TSH levels – 0.4 to 4.5 mIU/L
  • Grade 1 subclinical hypothyroidism – 4.5 and 9.9 mIU/L TSH levels
  • Grade 2 subclinical hypothyroidism – 10 mIU/L or higher TSH levels

Most patients diagnosed with Subclinical Hypothyroidism are diagnosed with Grade 1, wherein their TSH levels are less than 10 mIU/L, and the T3 and T4 levels are in the normal range.

How is Subclinical Hypothyroidism Treated?

One of the most common questions from our patients at Queen’s Gynecology is, “Does Subclinical Hypothyroidism need to be treated?”

Well, the answer can be subjective. There are many ongoing debates suggesting that patients with TSH levels less than 10 mIU/L can reverse the impacts of the condition through lifestyle modifications and supplementation.

However, if the TSH levels are 10 mIU/L or higher, that’s when things take a turn for the worse and demand the need for immediate treatment before the situation converts to overt hypothyroidism in the patient.

Since most people with subclinical hypothyroidism don’t show any symptoms, it isn’t surprising that the condition isn’t even diagnosed in the first place. In cases where we have a formal diagnosis, the level of TSH in the reports determines whether or not the patient needs treatment.

One of the reasons some doctors avoid treatment for subclinical hypothyroidism is to reduce the risks of thyrotoxicosis, which leads to the excess production of thyroid hormone in the body. This holds especially true for patients above the age of 65.

The “wait and see” approach is common in subclinical hypothyroidism instead of getting the patient on any kind of medication that could lead to far worse complications in the long run.

Following are situations related to Subclinical Hypothyroidism that demand treatment:

  • If the TSH levels in the patient are 10 mIU/L or higher.
  • If the patient is young or middle age and is experiencing symptoms related to hypothyroidism.
  • If the patient is at risk of developing cardiovascular complications.

Furthermore, if you are trying to conceive or are planning to undergo IVF, having risks of subclinical hypothyroidism might interfere with the conception. In such cases, we discuss the best treatment route with our experienced gynecologists at Queen’s Gynecology to ensure there are no interruptions in the pregnancy journey of the patient.

What are the Complications Associated with Subclinical Hypothyroidism?

Subclinical hypothyroidism presents itself in different ways in different patients. For example, some don’t experience any symptoms, while others might experience overt hypothyroidism symptoms.

However, despite how the condition manifests itself, one thing that’s crucial to know is the complications associated with it.

1. Risks of Cardiovascular Complications

Thyroid disorders have a proven record of contributing to the elevated risks of heart disease and other cardiovascular complications. Conditions like hypertension and high cholesterol are common in patients diagnosed with subclinical hypothyroidism.

In a study conducted with patients suffering from subclinical hypothyroidism, it was found that having TSH levels above 7 mIU/L enhanced the risks of congestive heart failure by two times. More conclusive studies need to be conducted.

2. Pregnancy Loss

If you didn’t know, the TSH levels during pregnancy fluctuate from the first to the third trimester. However, studies have found that pregnant women with subclinical hypothyroidism or other thyroid disorders are often at risk of pregnancy loss or a high-risk pregnancy.

The risks are also elevated in patients that have positive antithyroid peroxidase (TPO) antibodies in their blood while pregnant.

This is one of the primary reasons we prioritize a thorough thyroid profiling before and during pregnancy of our patients at Queen’s Gynecology to ensure that there are no risks involved.

Are There Any Ways to Prevent Subclinical Hypothyroidism?

Subclinical hypothyroidism presents itself in many ways. But, in most cases, the risks are elevated in individuals with a family history of thyroid or autoimmune disorders.

So, there’s nothing you can do to “prevent” the condition in such cases. However, once diagnosed, the patient can be on relevant supplementation, treatment, and introduce lifestyle modifications to ensure that the situation doesn’t worsen. WIth proper and timely intervention the patient is able to manage the condition better.

Is There a Specific Diet for Subclinical Hypothyroidism?

Diet plays a crucial role in the mix when discussing lifestyle modifications. Eating a healthy, balanced, and nutritious diet is key in regulating subclinical hypothyroidism.

However, keep in mind that the main trigger is iodine deficiency, which contributes to the disorder. Hence, ensure you get the required daily iodine intake through iodized salt, saltwater fish, dairy products, eggs, etc.

According to the daily standard requirements, we need 150 micrograms of iodine daily. Hence, discuss your options with your healthcare provider and attune your diet accordingly.

When is the Right Time to Contact a Doctor for Subclinical Hypothyroidism?

If you have a family history of thyroid disorders, you must get frequent thyroid health screening tests to ensure everything is right with the thyroid gland.

Since subclinical hypothyroidism doesn’t inflict symptoms in most patients, determining the “right time” to see a doctor can be challenging. However, if you do end up experiencing fatigue, poor metabolism, unexplained weight gain, etc., those symptoms warrant a doctor’s visit.

At Queen’s Gynecology, our specialists help you navigate the issue with a formal diagnosis and then tailored treatment of subclinical hypothyroidism for optimal results.


In conclusion, subclinical hypothyroidism is a condition with subtle symptoms that can easily be overlooked. Treatment options vary depending on the individual’s situation, with thyroid hormone replacement therapy considered for those experiencing symptoms or having specific risk factors.

Your worry is our concern at Queen’s Gynecology. Our team of specialists is here to guide you throughout the process, from diagnosis to recovery. For more details, contact us directly at +91 9654999888


How can I naturally reduce my subclinical hypothyroidism?

Besides being under a doctor’s supervision, ensuring that you are supplementing enough iodine in your diet, getting a good night’s sleep, working on stress management, etc., are some effective ways to keep the condition in check.

What foods should I avoid with subclinical hypothyroidism?

Like most thyroid disorders, you must avoid cruciferous vegetables and soy products if you have subclinical hypothyroidism.

Can you get rid of subclinical hypothyroidism?

There are conditions where patients with subclinical hypothyroidism with optimal treatment, supplementation, and lifestyle modifications can reverse the condition.

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