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Screening for Hypothyroidism

Screening is done to find a health problem early and treat it. Tests are often given to people who do not have signs but who may be at high risk for the health problem.

Screening Guidelines

Groups have differing screening guidelines. Talk to your doctor about whether you should have screening tests.
Screening may be needed in groups that are at higher risk, such as:
  • All newborn infants (required in many states)
  • Pregnant women with or without goiter
  • People with:
    • Prior thyroid problems
    • Other family members who have had thyroid disease
    • An autoimmune disease, such as type 1 diabetes
    • Mental health problems, such as those using lithium
    • High cholesterol
    • A thyroid nodule
    • Down syndrome

Screening Tests

A physical exam may show signs of hypothyroidism, such as dry skin, a slow pulse, or slowed reflexes. Your health history may show symptoms of weight gain, tiredness, and constipation.
The best screening tool is a blood test that measures thyroid-stimulating hormone (TSH). A high level of TSH points to hypothyroidism. If this is high, then your doctor may order a free thyroxine (FT4).


Jonklaas J, Bianco AC, Bauer AJ, et al. Guidelines for the treatment of hypothyroidism. Thyroid. 2014 Dec;24(12):1670-751.
Hypothyroidism (underactive thyroid). National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: Updated August 2016. Accessed May 20, 2019.
Hypothyroidism in adults. EBSCO DynaMed website. Available at: Updated July 20, 2018. Accessed May 20, 2019.

Revision Information

  • Reviewer: EBSCO Medical Review BoardJames P. Cornell, MD
  • Review Date: 03/2019
  • Update Date: 05/20/2019
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