Godbole Neha P, Koester Margaret, Marcus Erin N
University of Miami Miller School of Medicine, Miami, FL, USA.
Department of Internal Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.
Int J Womens Health. 2023 Oct 9;15:1515-1522. doi: 10.2147/IJWH.S397129. eCollection 2023.
Hypothyroidism is a common disease that is more prevalent in female populations. The purpose of this paper is to discuss the evidence, risks, and benefits of screening asymptomatic women for hypothyroidism. There is lack of evidence to support clinical management of asymptomatic individuals with an elevated TSH and normal serum thyroxine levels. Patients with subclinical hypothyroidism, especially the elderly, are at risk of overtreatment. Given these considerations, the majority of US and UK professional organizations do not support universal screening. Many do offer caveats for special groups, including pregnant people, who may need screening if there are clinical symptoms or family history of autoimmune disease. In conclusion, targeted screening may be best recommended based on risk factors, symptoms, and clinical suspicion, rather than at a universal level.
甲状腺功能减退症是一种常见疾病,在女性人群中更为普遍。本文旨在讨论对无症状女性进行甲状腺功能减退症筛查的证据、风险和益处。缺乏证据支持对促甲状腺激素(TSH)升高而血清甲状腺素水平正常的无症状个体进行临床管理。亚临床甲状腺功能减退症患者,尤其是老年人,有过度治疗的风险。考虑到这些因素,美国和英国的大多数专业组织不支持普遍筛查。许多组织确实对特殊群体提出了注意事项,包括孕妇,如果有临床症状或自身免疫性疾病家族史,可能需要进行筛查。总之,基于风险因素、症状和临床怀疑进行有针对性的筛查可能是最好的建议,而不是普遍进行筛查。