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If sub-clinical and not treated it may revert to normal or stay the same or progress to clinical
more likely to progress if high levels of Abs and higher TSH for longer

Rx with thyroxine if .... TSH >10, or TSH 4.5-10 with Sx/pregnant/abN lipids/Abs+ve/ovulation dysfunction
Aim for TSH 0.5-2.5
Recheck T4 and TSH 3/12thly till stable then yearly (check 6-8/52 post dose change)

''Thyroxine dose'' - start at 50mcg daily (or 25 if elderly / subclinical/ IHD(or severe Sx)) 
average 100mcg F, 125mcg M
Rx - prevents progression to overt plus resolves Sx, mood, cognition and abN lipids
Do not let TSH fall below 1 or you get neuropsych Sx, osteoporosis and AF

Note ....
Rx is lifelong
long half life - so takes 2/52 for effect to be felt and maybe 6/12 till Sx fully resolve
missing one tab OK but more than that Sx may recur
take tabs on empty stomach
in UK - gives you free prescriptions
adjust dose with 25mcg increments
elderly with CVS disease - titrate up slowly
beware if pituitary problem - assess adrenals as needs steroids pre thyroxine
No evidence that liothyronine with levothyroxine is useful
Note - Iron decreases levothyroxine absorption - so give 2 hrs apart

''Side Effects''
Hyperthryoidism
reduced bone mineral density
worsening angina
AF