Looking for Hashimoto’s Thyroiditis:22-Year-Old Woman with Elevated TSH and Normal Free T4

Presenting Author: Afnan Moh'd Ayman Abu Sarar, BS, MD

Co-Authors: Afnan Abu Sarar, MD, AU/UGA Medical Partnership, Athens, GA, Theresa M. Rohr-Kirchgraber, MD, Internal Medicine, AU/UGA Medical Partnership, Athens, GA.

Subclinical hypothyroidism may not be “subclinical” to patients who may have vague, concerning symptoms. Hashimoto thyroiditis, an autoimmune disorder characterized by the gradual onset of a chronic lymphocytic thyroiditis in which the diagnosis is often delayed if the thyroid peroxidase antibodies (TPO) are not checked. In this case, the patient’s persistence led to the diagnosis. Though the treatment of subclinical hypothyroidism is controversial, we support that the recognition of the presence of the TPO antibodies indicates that the autoimmune process will continue and that management would include thyroid replacement earlier than has been recommended for subclinical hypothyroidism. Proactive thyroid health management is crucial, especially for women of reproductive age, due to the impact on fertility and overall well-being.

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