Decision Making in Subclinical Thyroid Disease

Med Clin North Am. 2021 Nov;105(6):1033-1045. doi: 10.1016/j.mcna.2021.05.014. Epub 2021 Sep 7.

Abstract

Subclinical thyroid disease is frequently encountered in clinic practice. Although overt thyroid dysfunction has been associated with adverse clinical outcomes, uncertainty remains about the implications of subclinical thyroid disease. Available data suggest that subclinical hypothyroidism may be associated with increased risk of cardiovascular disease and death. Despite this finding, treatment with thyroid hormone has not been consistently demonstrated to reduce cardiovascular risk. Subclinical hyperthyroidism has been associated with increased risk of atrial fibrillation and osteoporosis, but the association with cardiovascular disease and death is uncertain. The decision to treat depends on the degree of thyroid-stimulating hormone suppression and underlying comorbidities.

Keywords: Decision making; Subclinical hyperthyroidism; Subclinical hypothyroidism.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Atrial Fibrillation / epidemiology
  • Cardiovascular Diseases / epidemiology
  • Clinical Decision-Making*
  • Cognition Disorders / epidemiology
  • Comorbidity
  • Humans
  • Hyperthyroidism / epidemiology
  • Hypothyroidism / epidemiology
  • Osteoporosis / epidemiology
  • Risk Factors
  • Thyroid Diseases / blood
  • Thyroid Diseases / epidemiology*
  • Thyrotropin / blood
  • Thyroxine / blood

Substances

  • Thyrotropin
  • Thyroxine