Subclinical Hypothyroidism – When you suspect you have a thyroid issue

Let’s explain Subclinical Hypothyroidism since January is World Thyroid Awareness Month with the intention of increasing awareness about thyroid disease. While many people worldwide have a diagnosed thyroid condition, those left undiagnosed or untreated can also experience myriad thyroid-related issues.  

So, what makes someone ‘subclinical’?

SH is detected via blood tests showing an increased Thyroid-stimulating-hormone (TSH) level with normal free thyroxine (T4) levels. (1) The “wait and see” approach is often advised by doctors. It can be frustrating for patients who must repeat blood tests until their T4 levels decrease enough to be diagnosed with hypothyroidism and subsequently bed thyroid medication.

SH is also called mild hypothyroidism and is considered a sign of early thyroid failure. (2) About 50% of people with SH also have thyroid antibodies (2), in which case their diagnosis is early stage, leading to autoimmune thyroiditis. Autoimmunity is the most common cause of SH (3), with an increased likelihood of disease progression.

Who is at risk of subclinical hypothyroidism?

SH is ubiquitous among ageing and older women, affecting about 10% of women above 55 (3), up to 20% of females (3), and up to 20% of females (3) and up to 20% of females aged over 60. (1)

A GP or specialist is more likely to recommend thyroid medication in cases considered to be more ‘at risk’, including (4)

• pregnancy or intending to become pregnant
• ovulatory dysfunction or infertility
• children and adolescents
• presence of thyroid antibodies (early stage Hashimoto’s)
• goitre (enlarged thyroid gland)

Pregnant women are one of the only parts of the population treated for SH routinely with medication to decrease the risk of pregnancy complications and effects on infant cognitive development. (2) This approach often extends to women trying to conceive as a preventative strategy, while extensive tissue changes to the thyroid gland, such as goitre, also provide good reason to medicate.

What are the signs and symptoms of subclinical hypothyroidism?

The signs of SH are demonstrated via blood tests and thyroid ultrasound. No particular symptom complaint definitively predicts SH. A varied clinical presentation means a range of symptoms may be present includi,ng: (2)(5)

• weight gain
• fatigue
• poor concentration and mild memory impairment
• depression and mood change
• muscle pain and weakness
• menstrual irregularities
• constipation
• cold intolerance

What can I do to prevent and manage subclinical hypothyroidism?

Staying in good health by eating well, exercising regularly, and prioritising healthy sleeping patterns and stress management techniques are good strategies. Smoking is closely related to thyroid function, especially in SH (6) so quitting is always a good idea.

Talking to a naturopath can provide you with a range of tools to address any issues before they progress. The good news is thyroid function has the potential to normalise spontaneously, with some findings indicating this may occur in up to 40% of cases. (3)

To best manage, SH, speak to your doctor about getting a thyroid ultrasound and discuss the time frame for regular checks via blood tests. Initially, you might retest every 4-12 weeks, then every 3-6 months until a pattern is established. Make sure that testing includes thyroid antibodies and aim to get repeat testing if positive. The decision on whether or not to treat with medication should always be individualised (2) and seeking further advice is always worthwhile.

How can a Naturopath help with subclinical hypothyroidism?

Naturopathy can provide complementary medicine alongside a prescription for SH, or alternative therapies when pharmaceutical medication is not required. In either case, Naturopathy offers a safe and effective option to support the thyroid gland, thyroid hormones and autoimmunity, helping to address any symptoms you are experiencing. Natural medicine also provides reassurance that working preventatively may stop or slow the progression of thyroid dysfunction. If you are currently being left untreated for subclinical hypothyroidism or suspect you are undiagnosed, we are here to assist you on your journey to better thyroid health.

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