• Journal of Korean Medicine for Obesity Research
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• v.6 no.2
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• pp.29-41
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• 2006

Subclinical hypothyroidism is defined as a normal serum free thyroxine level combined with an elevated thyroid stimulating hormone level. The causes of subclinical hypothyroidism are the same as those of overt hypothyroidism. There is good evidence that subclinical hypothyroidism is associated with progression to overt disease. The management of subclinical hypothyroidism is remains controversial. Patients with a serum thyroid stimulating hormone level greater than 10 mU/L have a higher incidence of elevated serum low-density lipoprotein cholesterol concentrations; however, evidence is lacking for other associations. There is insufficient evidence that hormone treatment of subclinical hypothyroidism is beneficial. The use of thyroid stimulating hormone level lone as a diagnostic and assessment tool for hypothyroidism is inadequate because this test cannot identify numerous conditions this sentence is unclear in its meaning. Using an expanded list of clinical signs and symptoms associated with dysfunction of the Hypothalamus-Pituitary-Thyroid axis, it is possible to hypothesize that subclinical hypothyroidism may be more common in a population of patients with early signs of age-related diseases than most practitioners realize. To improve thyroid function in subclinical hypothyroidism patients, practitioners should become familiar with foods and nutrients that can hinder or support thyroid function.

• The Journal of Korean Medicine
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• v.29 no.3
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• pp.38-49
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• 2008

Objectives: Though overt thyroid dysfunction is well recognized to affect serum lipid profiles and obesity, there are conflicting reports on the effect of subclinical hypothyroidism on serum lipid profiles and obesity. In most reports, the definition of the upper normal limit of serum thyroid stimulation hormone (TSH) of 4.0${\sim}$5.0mU/L has been used to diagnose. However, recent studies have suggested a much lower TSH cut off with an upper limit of 2.5mU/L, because >95% of rigorously screened normal euthyroid volunteers had serum TSH values between 0.4 and 2.5mU/L. Therefore we defined subclinical hypothyroidism as a TSH level greater than 2.5mU/L. We sought to evaluate the correlations of subclinical hypothyroidism with obesity index and serum lipid profiles Methods: TSH levels were measured in 6190 men and 4223 women that participated in health examination and free T4, lipid profiles (total-cholesterol, triglyceride, LDL-C), and obesity index (body mass index, body fat, waist circumference, C-reactive protein) were also measured. Results: There were significant differences of triglyceride between subclinical hypothyroidism men and normal control subjects. In women, there were also significant differences of triglyceride and LDL-C between subclinical hypothyroidism and normal control subjects. Subclinical hypothyroidism women showed significant correlations of TSH with total cholesterol, LDL-C, triglyceride, and C-reactive protein. Subclinical hypothyroidism men and women with a TSH level 2.5${\sim}$4.0mU/L had significant differences of triglyceride and body fat. In men, there were significant differences of waist circumference andC-reactive protein. In women, there were significant differences of LDL-C. Conclusions: We have demonstrated correlations of subclinical hypothyroidism with serum lipid profiles and obesity index. These findings suggested that subclinical hypothyroidism people had an increased risk of dyslipidemia and obesity. Subclinical hypothyroidism people with a TSH level 2.5${\sim}$4.0mU/L may be also considered suspect since it may signal a case of evolving thyroid underactivity eligible to be prevented.

• Journal of Society of Preventive Korean Medicine
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• v.12 no.1
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• pp.127-134
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• 2008

This study was carried out in 14,443 subjects(8,706 men, 5,737 women, mean age $41.8{\pm}9.16$) who visited the health promotion center of one university hospital. Serum $T_3$, $T_4$ and TSH concentrations were measured with CIA using commercial kits on ADVIA Centaur Assay and Serum total cholesterol, triglyceride, and HDL-cholesterol were measured by auto-analyzer Hitach 7600 in enzyme method. 1. The prevalence of subclinical hypothyroidism was 12.6/1,000 population(men 6.0/1,000, women 22.7/1,000) and as high as about 4 times in women than in men. 2. In subclinical hypothyroidism, the values of total cholesterol and LDL-cholesterol were significantly high by 5.5 mg/dL, 4.6 mg/dL compared with normal group(p<0.05). 3. In all the tested hypercholesterolemia and hyperLDL-cholesterolemia, were correlated with TSH. There is higher correlation in women group than men group. These results indicate that the subclinical hypothyroidism and dyslipemia significantly correlated. Especially, it is very important to find that the hypercholesterolemia and hyperLDL-cholesterolemia are the high risk factors of atherosclerosis. Therefore, it is essential for the group of subclinical hypothyroidism to take the cholesterol, LDL-cholesterol and serum lipid test as well as thyroid function test.

• The Journal of Internal Korean Medicine
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• v.39 no.6
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• pp.1281-1289
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• 2018

Objectives: This study is the first report on a case of subclinical hypothyroidism treated with Modified Er-Xian Decoction, which is rarely used in Korea. Methods: Patients were treated for 3 months with Modified Er-Xian Decoction and their therapeutic effects were evaluated through thyroid function tests and Spleen-Kidney deficiency Questionnaire. Results: Initial improvement was apparent after the administration of Modified Er-Xian Decoction. After 3 months of treatment, the patient 's Spleen-Kidney deficiency index improved significantly, and thyroid hormone levels returned to normal. Conclusions: In this case report, symptoms and biochemical improvement were confirmed based on a single herbal medicine prescription for subclinical hypothyroidism. It is necessary to verify the effect of this prescription through well - established clinical trials.

• Korean Journal of Biological Psychiatry
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• v.14 no.1
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• pp.68-71
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• 2007

Quetiapine is an atypical antipsychotic drug with a benign side effect profile. However, recent studies have reported that thyroid dysfunction is associated with quetiapine treatment. The authors report a patient with DSM-IV bipolar I disorder who developed subclinical hypothyroidism during quetiapine treatment. The patient showed no significant clinical symptoms, but only abnormal thyroid function test findings including antithyroglobulin antibody. The abnormal thyroid function test findings were normalized after discontinuation of quetiapine. The subclinical hypothyroidism developed during quetiapine treatment may be associated with autoimmune process.

• The Korean Journal of Nuclear Medicine
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• v.20 no.1
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• pp.67-73
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• 1986

Subclinical hypothyroidism can be defined as an asymptomatic state in which a reduction in thyroid activity has been compensated by an increased TSH output to maintain a euthyroid state. We analysed clinical features, laboratory data, and pathologic findings in 3g cases of subclinical hypothyroidism who were diagnosed at the Dept. of Internal Medicine, Chungnam National University Hospital from Aug. 1984 to June, 1985. 1) The age distribution was from sixteen to sixty-nine and mean a9e was 34.8. Peak incidence was in the 4th decade and 3rd, 5th, 6th decade in order. 2) The sex distribution showed female preponderance with a ratio of 18.5 to 1. 3) The major presenting manifestations were nonspecific ones such as fatigue, indigestion, and anorexia. 4) Physical examination revealed diffuse goiter in 47.6%. Major abnormalities were no gross abnormality (30.9%), nodular goiter and facial edema. 5) There was no significant difference of the basal serum $T_3\;and\;T_4$ concentrations between subclinical hypothyroidism and normal controls (p>0.05). 6) The basal serum TSH concentration of subclinical hypothyroidism $(32.61{\pm}14.95{\mu}U/ml)$ was significantly higher than that of normal controls $(3.92{\pm}1.05{\mu}U/ml)$ (p<0.005). 7) Microsomal antibody was detected in 80.6% and thyroglobulin antibody was detected in 30%. 8) The pathologic findings in 26 cases revealed Hashimoto's thyroiditis in 76.9% (lymphocytic type, 34.6%; oxyphilic type, 26.9%; fibrotic type, 15.4%). The others were adenomatous goiter(15.4%), adenomatous carcinoma (3.8%) and subacute thyroiditis(3.8%).

• Journal of Haehwa Medicine
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• v.21 no.1
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• pp.97-101
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• 2012

We treated a 18 year-old female patient. The main symptoms were Low back pain, Dyspepsia, Anorexia. She want to check blood test spontaneously and we diagnosed her as subclinical hypothyroidism and prescribe herbal medicine three times a day. We observed clinical symptoms and Free T4, T3, TSH levels. After the treatment, The main symptom were improved and TSH levels fell. This case shows that herbal medicine has an effect on subclinical hypothyroidism.

• Korean Journal of Bronchoesophagology
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• v.3 no.1
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• pp.101-108
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• 1997

Hypothyroidism is not uncommon complication of therapy for head and neck cancer. A series of 52 patients treated with either radiotherapy alone or combined with surgery was retrospectively studied. Diagnostic procedure included total T3, T4 and TSH measured by radioimmunoassay. The rate of hypothyroidism was 25% (subclinical 15.4%, clinical 9.6%). The incidence of hypothyroidism increased to 40% when radiotherapy was combined with surgery. Risk factors influenced a high incidence of hypothyroidism were : tumor stage, primary tumor site, combination of radiotherapy and surgery (especially combined with laryngectomy). We advocate routine monitoring of head md neck cancer patients for hypothyroidism after treatment and recommend levothyroxine replacement therapy for subclinical hypothyroidism.

• The Journal of Internal Korean Medicine
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• v.28 no.3
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• pp.624-631
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• 2007

Hypothyroidism is a common disease of the endocrinal system, characterized by fatigue, cold intolerance, bradycardia, and so on. Subclinical hypothyroidism is a common biochemical abnormality which can be found in routine screening tests of thyroid function. It is defined as an asymptomatic state which characterized by normal free thyroxine(FT4) and elevated thyroid stimulating hormone(TSH) levels. The purpose of this study was to evaluate the effect of treatment with palmijihwang-tang and to observe the changes in triiodothyronine(T3), free thyroxine(FT4), thyroid stimulating hormone(TSH) level and VAS of cold intolerance, hoarseness, dry skin. After the treatment, triiodothyronine(T3) increased from 57.12ng/dl to 120.53ng/dl. Free thyroxine(FT4) increased from 12.59pg/ml to 14.21pg/ml. Thyroid stimulating hormone(TSH) decreased from 10.61mU/L to 1.57mU/L. Cold intolerance, hoarseness and dry skin changed for the better. These results support a role for oriental medical therapy in treating subclinical hypothyroidism. Further case studies of herbal treatment of this ailment are needed.

• Safety and Health at Work
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• v.12 no.3
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• pp.390-395
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• 2021

Background: Health-care providers typically undergo shift work and are subjected to increased stress. Night shift work may induce disturbed sleep cycles and circadian rhythm. The objective of this study was to explore if night shift workers (NSWs) show an increased risk of abnormal thyroid-stimulating hormone (TSH). Methods: We conducted a retrospective cohort study of 574 employees without thyroid disease and abnormal TSH at baseline who underwent annual check-ups between 2007 and 2016 in a medical center. NSWs were defined as those with working time schedules other than daytime hours. We calculated the incidence rate and estimated the adjusted hazard ratio (HR) for incident abnormal TSH and subclinical hypothyroidism compared with non-NSWs using a Cox regression model. Results: A total of 56 incident abnormal TSH cases and 39 subclinical hypothyroidism cases in NSWs were identified during 3000 person-years of follow-up. In models adjusted for age, sex, obesity, and working departments, we found no increased relative risk for incident abnormal TSH (HR: 0.72, 95% confidence interval: 0.33-1.60) or subclinical hypothyroidism (HR: 0.52, 95% confidence interval: 0.19-1.45) when comparing NSWs to non-NSWs; nor were incidence rates significantly different among exclusively medical employees after excluding administrative staff. Conclusion: In this hospital-based nine-year follow-up retrospective cohort study, NSWs were not associated with increased relative risk of incident abnormal TSH and subclinical hypothyroidism, in contrast to previous cross-sectional studies.