Subclinical hyperthyroidism is primarily a laboratory
diagnosis that may be present in up to 3.9%
of the population over age 65. Manifestations
may include affective disorders. Decreased bone
density has been clearly demonstrated, especially
in postmenopausal women, and risk of fractures
may be increased in elderly women. Finally, a
number of cardiac effects of subclinical hyperthyroidism
have been noted, most significantly an
increased tendency to atrial arrhythmias. Antithyroid
treatment may not be presently indicated
for all patients with persistently suppressed
serum TSH levels and normal concentrations of
peripheral thyroid hormones. Instead, risks and
benefits of definitive therapy must be determined
on a case-by-case basis. Further research into the
effects of and optimal therapy for subclinical
hyperthyroidism is clearly warranted.
Since submission of this article for Thyroid International, a Clinical Practice Discussion of subclinical hyperthyroidism has been published 63 . |
