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Subclinical hypothyroidism is defined by an elevated serum thyroid-stimulating hormone (TSH) level along with a normal free thyroxine (T4) level. Whether it should be treated remains controversial. Currently, the best practical approach is to base treatment decisions on the degree of TSH elevation, thyroid autoimmunity, and associated comorbidities. The decision remains controversial and depends on the degree of TSH elevation, thyroid antibodies, and comorbidities.
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Azim et al. (2019) studied this question.
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