The Rotterdam Study reported SCH being an independent risk factor for myocardial infarction (MI) and atherosclerosis in elderly women, especially if they are positive for anti-TPO antibodies.20 An increased cardiovascular risk has been reported with TSH<10mIU/l in younger adult population (<70 years)21; it is suggested that levothyroxine replacement therapy in patients with SCH was associated with less CHD risk in these younger subjects.22 Here, TPO is linked to spindle cell hemangioma.