Current guidelines and expert opinion recommend threshold of treatment for SCH as >10 mIU/L for adults (Table 3).1, 5, 18, 83, 84, 85Treatment is recommended at TSH of 4.5 to 9.9 mIU/L only if younger than 65 to 70 years, having symptomatic hypothyroidism, or have definite indications (like CV disease or presence of anti-TPO Ab). The gene discussed is TPO; the disease is hypothyroidism.