Abstract
Hypothyroidism is the most common endocrine disorder both in primary and specialized care. A suitable knowledge of their pathophysiology and natural history allows us to distinguish between diseases with a self-limited or indolent presentation from those requiring closer attention and management, (especially multi-pathological patient, elderly or pregnant woman). We need to learn to decide with ease when to perform serum TSH determinations as screening or as follow-up in already diagnosed patients, to make appropriate treatment modifications and to consult or refer to the specialist in case of doubts. In most cases, diagnosis and treatment are easy, however differential diagnosis have to be taken in to account. To treat or not to treat, is a medical decision. Fluent patient-physician communication is crucial, since treatment is often chronic.
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