Regarding hypo and hyperthyroidism, if the patient is asymptomatic they should not be given any treatment

True or false ?Regarding hypo and hyperthyroidism, if the patient is asymptomatic they should not be given any treatment

The correct answer and explanation is:

Answer: False

Explanation:

It is false to say that asymptomatic patients with hypo- or hyperthyroidism should not be given any treatment. Even if a patient is asymptomatic, certain forms of thyroid dysfunction still require treatment or at least close monitoring, depending on the clinical context, lab values, and risk factors.

Hypothyroidism (Underactive Thyroid):

• Subclinical Hypothyroidism is when TSH is elevated but free T4 is normal and the patient has few or no symptoms.
  • Treatment may be considered especially if:
    • TSH is >10 mIU/L (even without symptoms).
    • The patient is pregnant or planning pregnancy.
    • The patient has a goiter or positive anti-thyroid antibodies.
    • There are cardiovascular risk factors (like high cholesterol or heart disease).
  • In mild cases with TSH <10 mIU/L and no symptoms, watchful waiting and periodic monitoring may be appropriate instead of immediate treatment.

Hyperthyroidism (Overactive Thyroid):

• Subclinical Hyperthyroidism is when TSH is low but T3 and T4 are still normal, and the patient is asymptomatic.
  • Treatment or close monitoring is important because untreated subclinical hyperthyroidism can lead to:
    • Atrial fibrillation.
    • Osteoporosis (especially in postmenopausal women).
    • Increased risk of cardiovascular events.
  • The decision to treat may depend on age, risk factors, and TSH level (especially if TSH is <0.1 mIU/L).

Conclusion:

Even in the absence of obvious symptoms, thyroid disorders can have serious long-term consequences if left untreated. Therefore, treatment decisions should be individualized based on lab results, risk factors, and potential complications—not just the presence or absence of symptoms. Regular monitoring, preventive treatment, or full intervention may be necessary in asymptomatic patients.