Clinical presentation: A 34-year-old woman was referred for evaluation of a subclinical hypothyroidism known for several years. She had no complaints. The patient intended to become pregnant.

Palpation: Both lobes were very firm.

Laboratory tests: TSH 5.83 mIU/L, aTPO 372 U/mL.

Ultrasonography revealed a moderately hypoechogenic thyroid without any nodules.

Suggestion daily 50 microgram levothyroxine.