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Submitted on February 22, 2005
Accepted on March 28, 2005
Departments of Endocrinology, Hospital Ramón y Cajal, Madrid (Spain) and Hospital General, Segovia (Spain), Endocrine Section, Washington Hospital Center, Washington, DC (USA)
* To whom correspondence should be addressed. E-mail: mibarsd{at}infomed.es.
Context Patients with subclinical hypothyroidism may revert to normal TSH values.
Objective To examine the time course of the normalization of TSH levels in subclinical hypothyroidism.
Design Prospective, observational study with no intervention, with a duration of follow-up of 12-72 months.
Setting Outpatients visiting an endocrinology clinic of a general hospital.
Patients Forty patients (32 women, mean age 62.8 ± 8.2 yr) with spontaneous subclinical hypothyroidism (TSH>5 mU/l and normal FT4). Each patient normalized their TSH values without thyroxine therapy throughout the follow-up.
Measurements TSH and FT4 levels were evaluated every 6 months.
Results Normalization occurred at a median time of 18 months (range, 6-60 months). Fifteen patients normalized their TSH levels during the first year of follow-up and 27 during the first two years. Ten patients normalized their TSH values at the fourth or fifth years. Only 4 patients reverted to TSH values less than 2 mU/l. Final TSH levels achieved by the patients was significantly correlated with the time elapsed until normalizing these levels (r=0.367; P = 0.020).
Conclusions There is no clear pattern of TSH normalization, although most patients normalize their TSH values early in the follow-up. The final TSH reached seems to be related to the time of normalization.
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