Is the diagnosis of hypothyroidism based on biochemical evaluation or clinical evidence?
There is a controversy between groups of physicians. One group essentially diagnoses hypothyroidism solely with laboratory tests, while the other relies more on clinical factors. Solid scientific evidence does not support the idea that the diagnosis of hypothyroidism can or should only be based on laboratory tests. This would imply that hypothyroidism only exists in patients with a serum TSH beyond the actual upper reference range, and serum thyroxine (T4) and triiodothyronine (T3) levels below the lower reference range, and neglects the clinical signs and symptoms. The IHS’s position is intermediate. The decision to initiate (thyroid) therapy should be based on both clinical and laboratory findings, and not solely on the results of a single test, exactly as expressed in the medical journals JAMA and Thyroid presenting the American Thyroid Association’s guidelines for use of laboratory tests in thyroid disorders (1). The diagnosis of hypothyroidism is further substantiated when treatme
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