Feature Article

Hypothyroidism: a definitive diagnosis guides treatment

Duncan J Topliss



Hypothyroidism may be obvious clinically but it has a wide spectrum of severity and can be very subtle. Many people with a normal thyroid function may present to GPs with complaints of mild symptoms suggestive of hypothyroidism. Therefore, biochemical confirmation of true hypothyroidism is mandatory. There is no evidence that thyroxine treatment of suggestive symptoms is beneficial when tests are normal.

Key Points

  • Hypothyroidism is a common condition, with most patients having subclinical hypothyroidism.
  • The most common cause of hypothyroidism in Australia is autoimmune disease of the thyroid gland.
  • A clinical diagnosis of hypothyroidism should be considered in the presence of one or more of its classic symptoms and signs.
  • People with normal thyroid function may complain of mild symptoms that suggest the possibility of hypothyroidism so that biochemical confirmation is mandatory.
  • Synthetic thyroxine is the best standard replacement therapy for patients with hypothyroidism.