{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:26:11Z","timestamp":1787847971212,"version":"build-2784847793"},"reference-count":19,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,10,5]],"date-time":"2015-10-05T00:00:00Z","timestamp":1444003200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The risk of progression of subclinical hypothyroidism (<jats:styled-content style=\"fixed-case\">SCH<\/jats:styled-content>) to clinical dysfunction is one of the factors considered in the decision to treat this condition. This study evaluated the natural history of <jats:styled-content style=\"fixed-case\">SCH<\/jats:styled-content> in women with <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content> \u226410 mIU\/l.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>This is a prospective study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Two hundred and fifty\u2010two women with <jats:styled-content style=\"fixed-case\">SCH<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content> levels ranging from 4\u00b75 to 10 mIU\/l were followed up for a period of 5 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 241 patients followed up until the completion of the study, 46 (19%) required levothyroxine (L\u2010T4) therapy, 55 (22\u00b78%) had spontaneous normalization of serum <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content>, and 140 (58\u00b71%) continued to meet the criteria for mild <jats:styled-content style=\"fixed-case\">SCH<\/jats:styled-content>. In multivariate analysis, only initial <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content> &gt;8 mIU\/l was a predictor of the need for L\u2010T4. In contrast, initial <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content> \u22648 mIU\/l and the absence of thyroiditis [negative antithyroid peroxidase antibodies (<jats:styled-content style=\"fixed-case\">TPOA<\/jats:styled-content>b) and ultrasonography (<jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>)] were predictors of <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content> normalization. Of note, the natural history was similar in <jats:styled-content style=\"fixed-case\">TPOA<\/jats:styled-content>b\u2010positive patients and patients with negative <jats:styled-content style=\"fixed-case\">TPOA<\/jats:styled-content>b but with positive US.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Most women with mild elevation of serum <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content>, ranging from 4\u00b75 to 10 mIU\/l, do not progress to overt hypothyroidism and even normalize their <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content>. However, initial <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content> seems to be a more important predictor of progression than the presence of antibodies or ultrasonographic appearance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.12939","type":"journal-article","created":{"date-parts":[[2015,9,5]],"date-time":"2015-09-05T15:22:56Z","timestamp":1441466576000},"page":"878-881","source":"Crossref","is-referenced-by-count":29,"title":["Natural history of subclinical hypothyroidism with <scp>TSH<\/scp> \u226410 mIU\/l: a prospective study"],"prefix":"10.1111","volume":"84","author":[{"given":"Pedro W. 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