When to Treat Subclinical Hypothyroidism. 1. TSH > 10 mIU/L ➡️ Treat in all patients, regardless of symptoms 🩺 Risk of progression to overt hypothyroidism and cardiovascular issues increases 2. TSH 4.5–10 mIU/L High-Risk Situations ➡️ Consider treatment if any of the following are present: •Symptoms of hypothyroidism (fatigue, cold intolerance, weight gain) •Positive anti-TPO antibodies (autoimmune thyroiditis) •Pregnancy or trying to conceive •Treat if TSH >2.5 mIU/L in 1st trimester •Goiter •
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