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previews",[218,229,234,239,246],{"type":219,"data":220},"video",{"readDurationInSeconds":221,"video":222},114,{"platform":223,"name":224,"url":225,"size":226},"YouTube","How to identify subclinical hypothyroidism.","https:\u002F\u002Fwww.youtube.com\u002Fwatch?v=k42bjuEKlzA",{"width":227,"height":228},200,113,{"type":230,"data":231},"free_text",{"readDurationInSeconds":232,"text":233},6.4,"\u003Cp>Sometimes spotting a case of hypothyroidism can be tricky! In this video from our \u003Ca href=\"https:\u002F\u002Fwww.medmastery.com\u002Fcourse\u002Fthyroid-disease-masterclass\">Thyroid Disease Masterclass\u003C\u002Fa>, you'll learn how to interpret lab findings to confidently diagnose a case of subclinical hypothyroidism.\u003C\u002Fp>",{"type":230,"data":235},{"readDurationInSeconds":236,"title":237,"text":238},13.6,"Join our Thyroid Disease Masterclass today!","\u003Cp>Master the management of thyroid disease. In our \u003Cstrong>\u003Ca href=\"https:\u002F\u002Fwww.medmastery.com\u002Fcourse\u002Fthyroid-disease-masterclass\">Thyroid Disease Masterclass\u003C\u002Fa>,\u003C\u002Fstrong> Dr Tracy Tylee–Clinical Assistant Professor of Endocrinology at the University of Washington–will review the pathophysiology of thyroid dysfunction, discuss the interpretation of thyroid tests, explain how pregnancy and certain medications can alter thyroid function, and evaluate the best treatment options.\u003C\u002Fp>",{"type":240,"data":241},"cta",{"readDurationInSeconds":242,"text":243,"buttonText":244,"buttonUrl":245},3.466666666666667,"Become a great clinician with our video courses and workshops","Start learning for free","https:\u002F\u002Fwww.medmastery.com\u002Fuser\u002Fregister",{"type":230,"data":247},{"readDurationInSeconds":248,"title":249,"text":250},68.26666666666667,"Video Transcript","\u003Cp dir=\"ltr\">\u003Cstrong>[00:00:00] \u003C\u002Fstrong>Occasionally, patients will have an elevated TSH but normal thyroid hormone levels. This is a condition known as subclinical hypothyroidism. There are multiple causes of this. One, early Hashimoto's thyroiditis or resolving thyroiditis, for patients on therapy taking inadequate doses of levothyroxine will result in labs such as this, and patients who have poor compliance with their medication. In fact, poor compliance is one of the primary reasons patients will present with labs such as this.\u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cstrong>[00:00:30]\u003C\u002Fstrong> You can see a patient on levothyroxine therapy who stops her medication for whatever reason. Their thyroid hormone levels will drop with a corresponding increase in TSH levels. When the patient restarts their medication, their T4 levels recover fairly quickly but the TSH does lag behind. So, if labs are checked during this time period, they will appear to have subclinical hypothyroidism. For patients on levothyroxine, it's always a good idea to ask how they were taking their medication and ensure that they are compliant. One of the concerns with subclinical hypothyroidism is, \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cstrong>[00:01:00] \u003C\u002Fstrong>which patients are likely to progress to overt hypothyroidism and thus, may require a bit closer follow-up. Patients who have a TSH greater than ten are at a higher risk of progressing to hypothyroidism, as our female patients. Patients who are on a high iodine diet are more likely to develop hypothyroidism, and people with autoimmune thyroid disease or positive TPO antibodies. For patients with TPO antibodies, they're twice as likely to develop hypothyroidism as patients who have negative TPO antibodies. \u003C\u002Fp>\u003Cp dir=\"ltr\">\u003Cstrong>[00:01:30]\u003C\u002Fstrong> So, do require a closer follow-up in the long term. Some patients with subclinical hypothyroidism need treatment despite normal thyroid hormone levels. It's typically recommended that pregnant women or women who are interested in pregnancy are started on treatment to normalize their TSH levels as well elderly patients with a TSH greater than ten should be started on levothyroxine therapy as well.\u003C\u002Fp>",{"courses":252,"showAwardsBelow":48},[253],{"id":254,"isFreeCmeCourse":255,"title":256,"type":257,"specialization":258,"teachers":260,"cmeCredits":262,"teacherIllustration":263,"backgroundImage":264,"relativeUrl":265,"lastChanged":266,"created":267,"description":268,"relativeURL":265,"meta":269},3749,false,"Thyroid Disease Masterclass","course",[259],"Endocrinology",[261],"Tracy Tylee, MD",3,"https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F99f55f0f-1e9c-413b-a826-11c1e0ec9808","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F99f55f0f-e1ca-46d7-9d36-ce0e3d322f8b","\u002Fcourses\u002Fthyroid-disease-masterclass","1767867649","1499852541","Using simple illustrations and elegant animations, we review the pathophysiology of thyroid dysfunction, discuss the interpretation of thyroid tests, explain how pregnancy and certain medications can alter thyroid function, and evaluate the best treatment options—this course will prepare you to confidently assess and effectively manage patients with thyroid disease.",{"duration":270,"quizzes":271,"lessons":272},5383,9,56,{"id":274,"name":261,"image":275,"profession":276,"relativeUrl":279,"specializations":280},3748,"https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F9c43cefc-88e6-4632-a711-cf90c6d98c24",{"name":277,"description":278},"Endocrinologist","Tracy is an Associate Professor of Endocrinology at the University of Washington, and Program Director for the Endocrinology Fellowship Program.","\u002Fteachers\u002Ftracy-tylee-md",[259],95,"2m",[284,312,331],{"id":285,"title":286,"text":287,"image":288,"author":296,"path":305,"readDuration":306,"readDurationFormatted":307,"internal":308},1351,"Starting statins as first-line therapy for hyperlipidemia","Starting statins: how to choose the right agent for your patient, match statin intensity to cardiovascular risk, and monitor effectively after initiation.",{"alt":289,"title":290,"size":291,"location":293},"Healthcare provider discussing starting statins with a patient and reviewing a medication bottle","",{"width":292,"height":292},660,{"bucket":294,"key":295},"public-drupal-medmastery-assets-production","\u002F2026-05\u002FC121(2)_magazine image.png",{"id":297,"title":298,"relativeURL":299,"image":300,"professionLong":301,"profession":302,"weight":304},1563,"Franz Wiesbauer, MD MPH","\u002Fteachers\u002Ffranz-wiesbauer-md-mph","https:\u002F\u002Fmedmastery-backend-prod-kjbeds.s3.eu-west-1.amazonaws.com\u002Fmedia\u002Fimages\u002F9c43cef0-41ee-4005-9e4a-d8711c816401","Franz is the founder and CEO of Medmastery. He is an internist with a specialization in cardiology and a master’s in public health from Johns Hopkins University.",{"name":303},"Internist",4,"\u002Fmagazine\u002Fstarting-statins-first-line-therapy",238,"4m",{"created":309,"updated":310,"published":311},1778960150,1779196374,1778961827,{"id":313,"title":314,"text":315,"image":316,"author":322,"path":324,"readDuration":325,"readDurationFormatted":326,"internal":327},1350,"How to recognize INOCA (ANOCA) on an exercise stress test ","Angina, abnormal stress test, clean coronaries—that's INOCA (or ANOCA), and it carries real risk. Learn to recognize and report it with exercise stress ECG.",{"alt":317,"title":290,"size":318,"location":320},"Illustration of the heart's coronary vasculature showing large coronary arteries and the extensive network of smaller vessels affected in INOCA (ischemia with nonobstructive coronary arteries).",{"width":319,"height":319},1200,{"bucket":294,"key":321},"\u002F2026-05\u002FC17(1)_magazine image_0.png",{"id":297,"title":298,"relativeURL":299,"image":300,"professionLong":301,"profession":323,"weight":304},{"name":303},"\u002Fmagazine\u002Fexercise-stress-ecg-inoca",141,"3m",{"created":328,"updated":329,"published":330},1778115738,1778799792,1778118255,{"id":332,"title":333,"text":334,"image":335,"author":341,"path":343,"readDuration":344,"readDurationFormatted":345,"internal":346},1348,"Hyperlipidemia screening: who, when, & what to measure","Testing for hyperlipidemia can help you mitigate your patients' cardiovascular risk. Learn who to screen and when, which measures to request, and how to stratify risk.",{"alt":336,"title":290,"size":337,"location":339},"Lipid panel blood sample tubes used to test for hyperlipidemia in a laboratory setting",{"width":338,"height":338},600,{"bucket":294,"key":340},"\u002F2026-04\u002FC121_magazine image.png",{"id":297,"title":298,"relativeURL":299,"image":300,"professionLong":301,"profession":342,"weight":304},{"name":303},"\u002Fmagazine\u002Ftest-for-hyperlipidemia",246,"5m",{"created":347,"updated":348,"published":349},1777403036,1777572381,1777412421,{"seo":351,"og":353},{"title":352,"description":213},"How to identify subclinical hypothyroidism | Medmastery",{"title":352,"description":213,"image":354},{"alt":290,"title":290,"size":355,"location":358},{"width":356,"height":357},860,482,{"bucket":294,"key":359},"\u002Fmigrated-images\u002FScreen Shot 2018-03-22 at 10.40.54 am.png",{"id":361,"created":362,"updated":363,"published":362},204,1522408943,1655189586]