Thyroid Science 3(1):1, 2008
Invited Editorial

Redefining Hypothyroidism:
A New Paradigm

Bo Wikland, MD*
(Full Text Free in pdf format)

*Hötorget Medical Centre, Sveavägen 13, SE-111 57 Stockholm, Sweden,
Contact: bo.wikland@comhem.se

KEYWORDS: fine needle aspiration cytology. hypothyroidism,
thyroid autoimmunity, thyroid autoantibodies

Introduction by Dr. John C. Lowe
Editor-in-Chief

We recently invited Dr. Bo Wikland of Stockholm, Sweden to write an editorial for Thyroid Science. We did so because of the importance of the research he and his colleagues have conducted and reported. That research involves what they term "subchemical hypothyroidism." After reading their reports in The Lancet, I noted this condition and its importance in a Thyroid Science editorial.

Here, however, Dr. Wikland himself explains to us the importance of this condition and how to diagnose it. His recognition of this clinical phenomenon and the solution he provides for patients suffering from it is nothing short of momentous. He calls for a paradigm shift in the diagnosis of hypothyroidism. In my view, such a shift is imperative: It is crucial to incalculable numbers of hypothyroid patients recovering their health, and it will be of vital interest to clinicians who are truly concerned about the well-being of these patients.

As Dr. Wikland explains, the shift he calls for entails including tissue evidence of thyroiditis in patients' diagnostic workups. This evidence can supplement biochemical test results that have indicated that patients are hypothyroid. Or, more importantly, the tissue evidence can show that the patient is hypothyroid when biochemical testing often fails to do so. Dr. Wikland uses and recommends tissue morphological evidence from "fine-needle aspiration cytology." (An informative website that explains find-needle aspiration cytology is available at no cost.) This diagnostic procedure has the potential to rescue patients whose clinicians would otherwise deny them the thyroid hormone treatment upon which their health and well-being depend. We are grateful to Dr. Wikland for composing his invited editorial for Thyroid Science.

Wikland, B.: Redefining Hypothyroidism—A Paradigm Shift. Thyroid Science, 3(1):1, 2008.
(Full Text Free in pdf format)