Evid Based Med 13:22 doi:10.1136/ebm.13.1.22
  • Therapeutics

Review: available evidence does not support a benefit for thyroid hormone replacement in adults with subclinical hypothyroidism

H Villar

Dr H Villar, Faculdade Estadual de Medicina de Marília, São Paulo, Brazil;



in adults with subclinical hypothyroidism, what is the effect of thyroid hormone replacement on cardiovascular mortality and morbidity, symptoms, and quality of life?

Search methods:

Medline, EMBASE/Excerpta Medica, CINAHL, and LILACS to May 2006; Cochrane Library (2006, Issue 1); Current Controlled Trials; references of relevant studies and systematic reviews; experts; and pharmaceutical companies.

Study selection and assessment:

randomised controlled trials (RCTs) that compared thyroid hormone replacement therapy (triiodothyronine [T3], thyroxine [T4], or both) with placebo or no treatment in adult outpatients with subclinical hypothyroidism and no severe illness. Treatment was given for ⩾1 month with ⩾3 months follow-up. Subclinical hypothyroidism was defined as a thyroid-stimulating hormone (TSH) concentration > upper limit of the test reference value. 12 RCTs (n = 485, >75% women) met the selection criteria; all compared …