Subclinical hypothyroidism in adults: Consensus statement of Indian thyroid society

Abstract

Subclinical hypothyroidism (SCH) is the most prevalent thyroid disorder in the Indian population. Since the last publication of the 2015 Indian Thyroid Society guideline on SCH, many significant clinical and scientific advances have occurred in the field. The aim of this guideline is to inform clinicians, researchers, and health policymakers about published evidence related to the diagnosis and management of SCH in adults. The specific clinical questions addressed in this consensus are based on the inputs from the task force of experts in the field of endocrinology and thyroid disease. The consensus statements are derived based on the latest published articles and evidence in SCH. A well-defined grading system has been followed for the critical appraisal of evidence and grading strength of recommendations. The guideline includes recommendations on the prevalence, causes, consequences, screening, diagnosis, and treatment of SCH. Other aspects detailed are the role of levothyroxine, its impact on the timing of treatment, and its benefits on various SCH consequences and populations. Therefore, these evidence-based recommendations are developed to inform clinical decision-making in the management of SCH in adults. While in some cases individualization of treatment is a necessity, these recommendations can provide standards of optimal care for patients with SCH.

Third-Generation Thyrotropin Receptor Antibody (TRAb) assay for predicting neonatal thyroid dysfunction in pregnant women with Graves’ disease

“…Inclusion criteria was all pregnant women with Graves' disease diagnosed either before or during pregnancy, with positive TRAB levels. Graves' disease was diagnosed based on symptoms and signs of hyperthyroidism, including diffuse goiter and/or Graves' ophthalmopathy with or without dermopathy along with suppressed pregnancy trimester speci c thyroid stimulating hormone (TSH), high total thyroxine (TT4) or free thyroxine (FT4) and positive TRAB levels 12 . Exclusion criteria were hyperthyroidism other than Graves' disease as well as not consenting for study.All the pregnant women who were on propylthiouracil during rst trimester were converted into equivalent doses of carbimazole in the second and third trimester on aiming to keep FT4 at high normal levels.…”