DOI: 10.36347/sjds.2023.v10i05.006

Pages: 108-112

Subclinical hypothyroidism is a prevalent thyroid disorder characterized by elevated thyroid-stimulating hormone (TSH) levels and normal free thyroxine (T4) levels. Its diagnosis and management in primary care settings present ongoing challenges and uncertainties. This systematic review aims to evaluate the current evidence regarding the diagnosis and management of subclinical hypothyroidism in primary care, with a focus on diagnostic criteria, clinical outcomes, and treatment approaches. A comprehensive search of electronic databases (PubMed, Embase, Cochrane Library) was conducted to identify relevant studies published in English within the last 10 years. Randomized controlled trials, cohort studies, and systematic reviews were included. Study selection, data extraction, and quality assessment were performed by two independent reviewers. The findings were synthesized descriptively, and meta-analysis was conducted when appropriate. A total of 25 studies met the inclusion criteria and were included in this review. Diagnostic criteria for subclinical hypothyroidism varied across the studies, with differing TSH thresholds used to define the condition. The clinical outcomes associated with subclinical hypothyroidism were heterogeneous, including cardiovascular risks, metabolic disorders, and quality of life. The management of subclinical hypothyroidism in primary care was diverse, ranging from watchful waiting to levothyroxine therapy. The benefits of levothyroxine treatment were inconclusive, with some studies reporting improvement in symptoms and lipid profiles, while others found no significant differences compared to placebo or observation. The diagnosis and management of subclinical hypothyroidism in primary care remain controversial. The variability in diagnostic criteria and inconsistent evidence on clinical outcomes and treatment efficacy complicate decision-making. Future research should focus on establishing standardized diagnostic thresholds, evaluating ....