The Society for Endocrinology (SfE) and the British Thyroid Association (BTA) have challenged recommendations made in a new clinical practice guideline on managing sub-clinical hypothyroidism (SCH).
The guidelines, published last month in the BMJ, recommend against thyroid hormones in “almost all” adults with SCH, with the guideline panel noting the recommendations may not apply to adults aged 30 years or below, or those with severe symptoms.
However, in a new statement, the SfE and BTA disagree with this recommendation, pointing out that it is based on a review of 21 trials with just 2,192 participants, more than 700 of whom were enrolled in what was originally a cardiovascular trial (TRUST) focused on older subjects. It said the guideline “does not provide sufficient evidence, especially in younger individuals" to support its claim.
“SfE and BTA are concerned that these recommendations could influence primary care physicians to dismiss patients with sub-clinical hypothyroidism, particularly younger ones, which could lead to some missing out on vital treatment if their condition progresses,” SfE and the BTA said.
The organisations said there is a need for larger studies, using more sensitive measures and considering factors, such as age, before drawing such strong conclusions on the benefits or disadvantages of SCH treatment.