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Feature Article

Subclinical thyroid disease: when should it be treated?

Eddy J Tabet, Ash Gargya

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Abstract

Subclinical hyperthyroidism and hypothyroidism are common and have been associated with many adverse effects, including cardiovascular disorders, cognitive impairment and reduced quality of life. Treatment decisions are clear if TSH levels are very high or low but should be individualised, taking into account patient factors such as age and comorbidities, for milder perturbations.

Key Points

  • Subclinical thyroid dysfunction is defined as an abnormal level of thyroid-stimulating hormone (TSH) in the presence of normal thyroxine and tri-iodothyronine levels.
  • Both subclinical hyperthyroidism and hypothyroidism have been associated with adverse effects, including cardiovascular disorders, cognitive impairment and reduced quality of life.
  • Patients with a TSH level below 0.1 mU/L or above 10 mU/L should be treated.
  • In patients with milder TSH perturbations, the decision to treat is influenced by factors such as patient age, comorbidities and cardiovascular risk.

    Picture credit: © Monkey Business/Stock.adobe.com. Model used for illustrative purposes only.

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