Primary hypothyroidism

Overview 
Theory 
Diagnosis 
Management 
Follow up 
Resources 

Thyroid-stimulating hormone (TSH) is the only test indicated for screening primary hypothyroidism.[32] Many countries screen all newborns for primary hypothyroidism to prevent intellectual disability.[33][34][35] The US Preventive Services Task Force determined that there is insufficient evidence to recommend for or against screening for thyroid disease in non-pregnant, asymptomatic adults.[32][36]

Screening in pregnancy

There is no evidence that universal screening in pregnancy improves pregnancy outcomes.[37][38] [ ] However, it seems prudent to perform targeted screening of pregnant women with increased risk of hypothyroidism.[39][40]

The American College of Obstetricians and Gynecologists recommends thyroid function testing in pregnant women who are at increased risk of thyroid disease (personal or family history of thyroid disease, type 1 diabetes, clinical suspicion of thyroid disease).[41]

The American Thyroid Association recommends screening for thyroid disease in pregnant women and those planning pregnancy if risk factors are identified.[29] This includes women with a history of thyroid disease or thyroid peroxidase antibodies, a family history of thyroid disease, symptoms of hypothyroidism, risk of iodine deficiency, type I diabetes mellitus, recurrent miscarriage, or a history of head and neck radiation.

Elevations in serum TSH concentrations during pregnancy should ideally be defined using pregnancy (trimester) and population-specific reference ranges.[29]

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