Subclinical Thyroid Dysfunction

doi:10.1001/archinte.1997.00440310023002

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Vol. 157 No. 10, 26 MAY 1997

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Subclinical Thyroid Dysfunction

Kenneth A. Woeber, MD, FRCPE

Arch Intern Med. 1997;157(10):1065-1068.

Abstract

Subclinical thyroid dysfunction may be defined as an abnormalserum thyrotropin concentration in an asymptomatic patient witha normal serum free thyroxine concentration. This article addressesthe prevalence, natural history, and potential pathophysiologicalconsequences of subclinical hypothyroidism and subclinical thyrotoxicosis.Subclinical hypothyroidism, which occurs in more than 10% ofwomen older than 60 years, may be accompanied by an unfavorableserum lipid profile and may lower the threshold for the developmentof major depressive disorder. Subclinical thyrotoxicosis, whichis most commonly due to thyrotropin-suppressive levothyroxinesodium therapy, may be associated with reduced bone mineraldensity in postmenopausal women and confers a 3-fold relativerisk for the development of atrial fibrillation. While thereare no outcome data to support therapeutic intervention in subclinicalthyroid dysfunction, some screening and management recommendationsare offered.

Arch Intern Med. 1997;157:1065-1068

Author Affiliations

From the Department of Medicine, University of California, San Francisco—Mount Zion Medical Center.

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