The Endocrine Society has responded to the final recommendation statement on screening for thyroid dysfunction issued by the United States Preventative Service Task Force (USPSTF) in support of screening in specific situations.

For non-pregnant, asymptomatic adults, the Task Force concluded there is insufficient evidence to assess the balance of benefits and harms of screening for thyroid dysfunction. The Endocrine Society supports screening for thyroid dysfunction in specific situations, such as in women who intend to become pregnant and are considered high risk for thyroid illness. This includes women who are >30 years old with:

  • Family history or autoimmune thyroid disease or hypothyroidism
  • Goiter
  • Known thyroid antibodies
  • Symptoms or clinical signs suggestive of thyroid hypofunction
  • Type 1 diabetes mellitus
  • Infertility
  • Prior history of preterm delivery
  • Prior therapeutic head or neck irradiation or prior thyroid surgery
  • Currently receiving levothyroxine replacement

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Further, the Society strongly supports testing all pregnant women for elevated TSH concentration by Week 9 or at the time of their first visit before and during pregnancy, or at least an aggressive finding to detect and test women at high risk. Women with known thyroid autoantibodies, a history of postpartum thyroiditis or Type 1 diabetes should have TSH measured at 6–12 weeks and six months postpartum, or as clinically indicated.

The USPSTF calls for additional research into thyroid disease screening studies, and encourages physicians and patients to discuss situations when testing and treatment may be appropriate.

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