Same thing?

[Pixipot]

Is sub- clinical & clinical hypothyroidism the same thing because anytime I write about clinical hypothyroidism on here (which I have been recently diagnosed with) people get back to me talking about sub- clinical?

[helvella Administrator]

The definitions are muddy.

I have understood sub-clinical to mean when there are no symptoms, just a laboratory test that is a little out high or low. For example, a TSH of 6 on a reference interval of 0.04 to 4.5.

However, it is often applied even when there are symptoms. If someone goes to a clinic because they have symptoms, it surely isn't sub-clinical! When those symptoms are classic symptoms of hypothyroidism, even more obviously so.

Frequently sub-clinical effectively means that the doctor is unwilling to treat. It only becomes clinical if they accept there are issues and commence treatment. In my view, an inversion of meaning in that it applies to what the doctors are, or are not, doing not what the patient is suffering.

[SeasideSusie Remembering]

Pixipot

SlowDragon gave you a link yesterday which showed a flow chart from gp-update.co.uk that explained this

gp-update.co.uk/Latest-Upda...

Raised TSH >5 with normal FT4 = subclinical

Raised TSH >5 with low (below range) FT4 = clinical

It's more usual to see here, and tends to be what doctors go by, rather than "clinical hypothyroidism":

TSH >10 = Primary (overt) Hypothyroidism - start Levo

TSH >5 but <10 with normal FT4 = subclinical

[SlowDragon Administrator]

Clinical - If TSH is over top of range and Ft4 under bottom of range the Doctor is obligated to start treatment

Sub-clinical - If TSH is over top of range and Ft4 within range a Doctor can choose to start treatment.

Often, as we see on here ....they refuse to start treatment for sub-clinical ....even if patient has lots of hypothyroid symptoms and is clearly suffering

High antibodies confirms autoimmune thyroid disease and is another strong reason to start treatment when sub clinical