Endogenous subclinical hyperthyroidism: who, when and why to treat

Abstract

Subclinical hyperthyroidism is defined as serum thyroid hormone levels within their respective reference ranges in the presence of low-undetectable serum thyrotropin-stimulating hormone levels. Subclinical hyperthyroidism is associated with important cardiovascular risk factors and negative effects on bone metabolism and structure. However, there are conflicting results on cardiovascular mortality and the risk of bone fractures. Treatment and management of subclinical hyperthyroidism is controversial. This article will address the necessity to treat this disorder in relation to the cause of hyperthyroidism, the patient’s age, the degree of thyroid-stimulating hormone suppression and the presence of comorbidities.

Keywords::

• bone
• cardiovascular risk
• cognitive function
• elderly
• heart
• osteoporosis
• prevalence
• progression
• subclinical hyperthyroidism
• symptoms
• thyroid autonomy
• thyrotropin

Acknowledgements

The author is grateful to Alfonso Gruossoe for writing assistance.

Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No funded writing assistance was utilized in the production of this manuscript.