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Subclinical hypothyroidism and subclinical hyperthyroidism.

Vahab Fatourechi¹

¹a Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. fatourechi.vahab@mayo.edu.

Expert Review of Endocrinology & Metabolism

|March 14, 2019

Summary

This summary is machine-generated.

Subclinical thyroid dysfunction, characterized by normal hormone levels and abnormal thyroid-stimulating hormone (TSH), requires careful management. Treatment decisions for subclinical hypothyroidism and hyperthyroidism depend on specific TSH levels and patient factors.

Keywords:

antithyroid antibody cardiac risk factor hyperthyroidism hypothyroidism subclinical hyperthyroidism subclinical hypothyroidism thyroid-stimulating hormone screening thyrotropin thyroxine therapy

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Area of Science:

Endocrinology
Internal Medicine
Thyroidology

Background:

Subclinical thyroid dysfunction is defined by normal peripheral thyroid hormone levels with abnormal serum thyroid-stimulating hormone (TSH).
Normal TSH reference range is 0.3-5.0 mIU/l.
It encompasses both subclinical hypothyroidism (elevated TSH) and subclinical hyperthyroidism (low TSH).

Purpose of the Study:

To outline diagnostic criteria for subclinical thyroid dysfunction.
To provide therapeutic recommendations based on TSH levels and clinical context.
To guide management strategies for patients with subclinical thyroid dysfunction.

Main Methods:

Review of diagnostic criteria for subclinical thyroid dysfunction.
Analysis of TSH levels in relation to normal reference ranges.
Evaluation of therapeutic interventions for subclinical hypothyroidism and hyperthyroidism.

Main Results:

Subclinical hypothyroidism with TSH >10 mIU/l warrants thyroxine therapy after excluding other causes.
TSH levels between 5.0-10.0 mIU/l suggest consideration for selective therapy.
Sustained subclinical hyperthyroidism (TSH <0.1 mIU/l) generally requires therapy, particularly in the elderly.

Conclusions:

Management of subclinical thyroid dysfunction should be individualized based on TSH levels.
Observation or selective therapy is advised for TSH levels between 0.1-0.3 mIU/l.
Timely intervention can mitigate potential risks associated with thyroid dysfunction.