Biochemical tests are important in diagnosis

Editor—Like Gordon R B Skinner and colleagues, we recognise that the clinical diagnosis of hypothyroidism is a challenge for general practitioners1; recent reviews of the published literature make it clear that the non-specific nature of the signs and symptoms of hypothyroidism means that biochemical tests of thyroid function (specifically serum thyroid stimulating hormone) are an essential component of the diagnosis.2 3 4 5

There were several shortcomings in the letter from Skinner and colleagues. The clinical criteria of hypothyroidism used are neither stated nor referenced. The method of selecting patients is …