Therapeutic strategies of subclinical hypothyroidism, including statin therapy

Abstract

Background: Thyroid disorders are an actual problem of contemporary medicine. Hypothyroidism represents the insufficiency of thyroid to secrete thyroid hormones in necessary quantities for human body. Primary hypothyroidism is the most common endocrine disease. Although the diagnosis and treatment of hypothyroidism is often considered simple, there are large numbers of people with this condition who are suboptimally treated. We are very concerned that some patients with and without thyroid disease are being inappropriately diagnosed and managed, using levothyroxine and other thyroid hormones, in ways which compromise patient safety. Subclinical hypothyroidism has multiple etiologies and manifestations. Appropriate treatment requires an accurate diagnosis and is influenced by coexisting medical conditions. Clinical symptoms of hypothyroidism are nonspecific and may be subtle, especially in older persons. Diagnosis and treatment of hypothyroidism is often considered simple and is mostly carried out in a primary care setting. The dangers of statin use in hypothyroid patients have been illustrated and the necessity for appropriate biochemical monitoring has been emphasized. Statin therapy is safe and effective when patients are appropriately diagnosed, educated, and followed up. Statins can be cautiously reinitiated once a euthyroid state has been established in patients who developed statin-induced myopathy while hypothyroid. Conclusions: Despite the fact that nowadays problems persist in the management of subclinical hypothyroidism, administration of statins in secondary dyslipidemia will prevent cardiovascular diseases especially atherosclerosis thus enhancing the quality of life of patients with hypothyroidism.