Clinical presentation: A 50-year-old woman was referred for evaluation of a minimally elevated TSH-level detected on routine blood test.

Palpation: no abnormality.

Hormonal investigation: TSH 4.31 mIU/L, FT4 13.1 pM/L, aTPO 218 U/mL.

Ultrasonography. The thyroid was moderately hypoechogenic and had a few more hypoechogenic small areas.

Diagnosis: Hashimoto's thyroiditis. Subclinical hypothyroidism.

Suggestion: yearly TSH test.