Screening for Thyroid Dysfunction
Authors: Robert A. Stern, James V. Hennessey
Journal: Annals of Internal Medicine (2015)

Letters6 October 2015Screening for Thyroid DysfunctionRobert A. Stern, PhD and James V. Hennessey, MDRobert A. Stern, PhDFrom Boston University School of Medicine and Harvard Medical School, Boston, Massachusetts.Search for more papers by this author and James V. Hennessey, MDFrom Boston University School of Medicine and Harvard Medical School, Boston, Massachusetts.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5141 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:LeFevre and colleagues (1) and Rugge and associates (2) used a well-defined, rigid approach to literature review to conclude that the evidence supporting identification of asymptomatic disease is insufficient. We are concerned that clinicians will conclude that thyroid function testing is unwarranted in all but the most symptomatic patients. Symptoms of thyroid dysfunction are subtle and nonspecific, vary substantially among persons, and are unreliable (3). LeFevre and colleagues conclude that subclinical hypothyroidism and levothyroxine replacement do not affect mood and neuropsychiatric function on the basis of 2 controlled studies that, based on design, the U.S. Preventive Services ...References1. LeFevre ML; U.S. Preventive Services Task Force. Screening for thyroid dysfunction: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2015;162:641-50. [PMID: 25798805] doi:10.7326/M15-0483 LinkGoogle Scholar2. Rugge JB, Bougatsos C, Chou R. Screening and treatment of thyroid dysfunction: an evidence review for the U.S. Preventive Services Task Force. Ann Intern Med. 2015;162:35-45. [PMID: 25347444] doi:10.7326/M14-1456 LinkGoogle Scholar3. Carlé A, Pedersen IB, Knudsen N, Perrild H, Ovesen L, Laurberg P. Hypothyroid symptoms and the likelihood of overt thyroid failure: a population-based case-control study. Eur J Endocrinol. 2014;171:593-602. [PMID: 25305308] doi:10.1530/EJE-14-0481 CrossrefMedlineGoogle Scholar4. Jorde R, Waterloo K, Storhaug H, Nyrnes A, Sundsfjord J, Jenssen TG. Neuropsychological function and symptoms in subjects with subclinical hypothyroidism and the effect of thyroxine treatment. J Clin Endocrinol Metab. 2006;91:145-53. [PMID: 16263815] CrossrefMedlineGoogle Scholar5. Parle J, Roberts L, Wilson S, Pattison H, Roalfe A, Haque MS, et al. A randomized controlled trial of the effect of thyroxine replacement on cognitive function in community-living elderly subjects with subclinical hypothyroidism: the Birmingham Elderly Thyroid study. J Clin Endocrinol Metab. 2010;95:3623-32. [PMID: 20501682] doi:10.1210/jc.2009-2571 CrossrefMedlineGoogle Scholar6. Joffe RT, Pearce EN, Hennessey JV, Ryan JJ, Stern RA. Subclinical hypothyroidism, mood, and cognition in older adults: a review. Int J Geriatr Psychiatry. 2013;28:111-8. [PMID: 22410877] doi:10.1002/gps.3796 CrossrefMedlineGoogle Scholar7. Cappola AR, Cooper DS. Screening and treating subclinical thyroid disease: getting past the impasse [Editorial]. Ann Intern Med. 2015;162:664-5. [PMID: 25799007] doi:10.7326/M15-0640 LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Robert A. Stern, PhD; James V. Hennessey, MDAffiliations: From Boston University School of Medicine and Harvard Medical School, Boston, Massachusetts.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L15-0392. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoScreening for Thyroid Dysfunction: U.S. Preventive Services Task Force Recommendation Statement Michael L. LeFevre , on behalf of the U.S. Preventive Services Task Force* Screening for Thyroid Dysfunction Albert L. Siu , Kirsten Bibbins-Domingo , and David C. Grossman Metrics 6 October 2015Volume 163, Issue 7Page: 564KeywordsClinical trialsCognitionDisclosureHyperthyroidismHypothyroidismProspective studiesQuestionnairesThyroidThyroid-stimulating hormoneThyroxine ePublished: 6 October 2015 Issue Published: 6 October 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...