The management of subclinical hypothyroidism (an elevated thyrotropin level with a normal free thyroxine level) should be guided by the degree of elevation of thyrotropin, the presence of symptoms, and other patient factors.
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Disclosure forms provided by the author are available with the full text of this article at NEJM.org.
Dr. Peeters reports receiving lecture fees from IBSA Institut Biochimique and Goodlife Fertility. No other potential conflict of interest relevant to this article was reported.
Author Affiliations
From the Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam, the Netherlands.
Address reprint requests to Dr. Peeters at the Department of Internal Medicine, Academic Center for Thyroid Diseases, Rm. D-430, Erasmus Medical Center, Postbus 2040, 3000 CA, Rotterdam, the Netherlands, or at [email protected].