What Doctors Don’t See: Subclinical Hypothyroidism

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Multiple difficult to diagnose conditions such as chronic fatigue syndrome, irritable bowel syndrome, and subclinical hypothyroidism and their associated symptoms are often discounted as part of growing older. Although there is some truth that the body becomes less efficient over time, it does not mean that one should settle for poor health simply because much of society has accepted it as a cost of living.

Basics of Subclinical Hypothyroidism

Subclinical hypothyroidism is a difficult to diagnose condition that is very similar to hypothyroidism proper. The subclinical modifier is used when tests of various thyroid hormones fall within “normal” ranges but the patient experiences hypothyroid-related symptoms. Essentially, those with subclinical hypothyroidism present normal levels but frequently feel fatigued, have difficulty thinking clearly, experience muscle pain, and have trouble losing weight. For those acquainted with hypothyroidism this should sound familiar.

Those with subclinical hypothyroidism may present similar symptoms to those with hypothyroidism but have a lower chance of being properly diagnosed. Primary issues associated with diagnosing subclinical hypothyroidism is that many doctors are unaware of it or don’t recognize it as a real medical condition. As patients, it is essential to understand the reality of subclinical hypothyroidism and recognize the importance of having it properly treated.

Both hypothyroidism and subclinical hypothyroidism share the same symptoms. Because hypothyroid symptoms appear on a spectrum, those with subclinical hypothyroidism will likely experience hypothyroid symptoms of reduced intensity. Signs that one’s thyroid is not functioning at its best include:

  • Hair and eyebrow thinning
  • Puffy face
  • Abnormal moods and depression
  • Intolerance to cold temperatures
  • Joint and muscle pain
  • Brain fog
  • Fatigue
  • Weight gain
  • Heavier periods

Even in the face of these symptoms doctor’s frequently take a passive approach and wait to see if one’s test results will eventually fall into the category of necessary treatment. This can cause one to experience suboptimal health for months or years simply because one’s tests did not break through a specific testing barrier.

Problems with Testing

Even if a patient presents symptoms such as fatigue, brain fog, weight gain, and sluggishness, if the test results do not back up a patient’s concerns, doctors frequently avoid diagnosis. Unfortunately, standardized lab tests are not an accurate picture of one’s health. The most widely utilized method of testing thyroid function is TSH (thyroid stimulating hormone). Because the range of “normal” has extended so drastically in both directions, TSH testing does little to gauge one’s thyroid function. Furthermore, multiple studies have found that TSH testing alone does not give an appropriate image of important thyroid-related substances such as T3 and T4. Greater still, TSH does not account for conversion issues that patients may have. The sad truth is that many medical practitioners rely solely on TSH testing to diagnose thyroid function. Therefore, those with subclinical hypothyroidism have little hope of acquiring an accurate diagnosis.

Medical guidelines state that TSH levels between 5 and 25 are rarely accompanied by symptoms. However, many patients experience notable symptoms even if their TSH falls between these two numbers. A better identifier of thyroid malfunction is TSH changes. If a patient’s levels shift from 3 to 7.5, many doctors will still wait to act because those numbers are considered within the healthy range. Changes of that magnitude in almost any area of the body can cause serious issues and the thyroid is no different.

Many doctors have become entrenched in the belief that thyroid treatment should only be administered when patient’s show extreme dysfunction. Counteracting this practice is the American Association of Clinical Endocrinologists who stated that TSH levels between 3.0 and 5.0 should be watched closely as it may signal a developing thyroid condition even though those numbers fall within the “normal” range. It is clear that recognition of subclinical hypothyroidism is an issue, but is there a need to treat it?

Why Subclinical Hypothyroidism Deserves Treatment

Those who experience subclinical hypothyroidism may have symptoms that reduce their quality of life. When one is feeling excessively fatigued and seeks medical assistance only to be met with the response that it is simply part of growing older, or that they just need to sleep more, it can feel like a slap in the face. Even though fatigue may be a common symptom in the modern era it should not be normalized. It is far better to optimize one’s health rather than accepting fatigue, brain fog, and weight gain as a cost of living.

It is estimated that nearly 8% of women and 4% of men have subclinical hypothyroidism. These numbers nearly double when looking only at individuals above the age of 60. Furthermore, this data is created using the broad range of “normal” thyroid levels. If the data were to be more accurate regarding suboptimal thyroid levels, the number of people with subclinical hypothyroidism would increase dramatically.

Subclinical hypothyroidism is essentially a less easily recognizable form of hypothyroidism. This means that many of the issues associated with poor thyroid function are still present among those with subclinical hypothyroidism even if they are not diagnosed. The most prominent danger of subclinical hypothyroidism is that it can go for years without proper treatment. If one is diagnosed early with a thyroid condition, there are usually methods of treating and optimizing it. However, if the condition is never officially diagnosed it can remain and continually degrade bodily function. Some of the ways this condition can inhibit one’s health is that it increases the risk of developing the following conditions:

Better Living through Treatment

Treatment of subclinical hypothyroidism should certainly be pursued as it can prevent the development of debilitating and life-threatening conditions. Optimization of one’s health is always going to provide benefits. Even if a patient does not recognize symptoms associated with subclinical hypothyroidism, optimization of the thyroid can be a revelatory and life-changing experience. If one suspects that they are hypothyroid, it is important that they find a physician who provides proper testing, diagnosis, and appreciation of subclinical hypothyroidism. Without respecting the existence and impact of this condition many will be left to suffer from an underactive thyroid.


1. https://thyroidpharmacist.com/articles/patients-subclinical-hypothyroidism-deserve-care-treatment/

2. http://www.thyroid-info.com/articles/subclinicalhypofaq.htm

3. https://www.restartmed.com/subclinical-hypothyroidism/

About Holtorf Medical Group

The Holtorf Medical Group specializes in optimizing quality of life and being medical detectives to uncover the underlying cause of symptoms, rather than just prescribing medications to cover-up the symptoms. We are experts in natural, prescription bioidentical hormone replacement and optimization, complex endocrine dysfunction, fibromyalgia, chronic fatigue syndrome and Lyme disease.

We’ve dedicated our practice to providing you the best in evidenced-based, integrative medicine that’s not only safe and effective, but provides measurable results.