Primary hypothyroidism

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

Thyroid-stimulating hormone (TSH) is the only test indicated for screening primary hypothyroidism.[69] Many countries screen all newborns for primary hypothyroidism to prevent intellectual disability.[70][71][72] The US Preventive Services Task Force determined that there is insufficient evidence to recommend for or against screening for thyroid disease in nonpregnant, asymptomatic adults.[69][73]

Screening in pregnancy

There is no evidence that universal screening in pregnancy improves pregnancy outcomes.[74][75] [ ] However, it seems prudent to perform targeted screening of pregnant women with increased risk of hypothyroidism.[76][77]

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).[78]

The American Thyroid Association recommends screening for thyroid disease in pregnant women and those planning pregnancy if risk factors are identified.[57] This includes women with a history of thyroid disease or antithyroid 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.[57]

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