Are we overtreating subclinical hypothyroidism in pregnancy?

The benefits of treating overt hypothyroidism during pregnancy include improved obstetric and neonatal outcomes. However, evidence for the management of subclinical hypothyroidism and appropriate treatment targets in pregnancy are lacking. Despite this, international guidelines have set a low TSH threshold for the diagnosis and treatment of both new and pre-existing hypothyroidism in pregnancy.1 2 This threshold potentially increases the prevalence of subclinical hypothyroidism in pregnancy and may "medicalise" women despite a lack of clear evidence that treatment improves outcome.