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Subclinical hyperthyroidism (SCHyper) is a biochemical diagnosis characterized by decreased serum thyroid-stimulating hormone (TSH) levels while maintaining normal serum concentrations of thyroxine (T4) and triiodothyronine (T3). This condition is often identified during routine thyroid function tests and can be indicative of early thyroid dysfunction. Despite the absence of overt hyperthyroid symptoms, SCHyper can have significant clinical implications, particularly affecting cardiovascular health and bone density. It is crucial to confirm the diagnosis through repeated testing over a period of months to rule out transient causes of TSH suppression.
| Aspect | Details |
|---|---|
| Definition | Biochemical diagnosis characterized by decreased serum TSH and normal serum T4 and T3 concentrations. |
| Diagnosis | Repeat serum TSH, T3, and T4 concentrations in 3-6 months before confirming diagnosis to rule out transient causes. |
| Grading | - Mild SCHyper: TSH 0.1-0.4 mIU/L |
| - Severe SCHyper: TSH <0.1 mIU/L | |
| Prevalence | Ranges from 0.5% in children to 15% in the elderly population. |
| Symptoms and Effects | - Can mimic adrenergic overactivity: palpitations, nervousness, tremor. |
| - Cardiovascular: higher heart rate, risk of supraventricular arrhythmias, increased left ventricular mass, impaired diastolic function, reduced exercise tolerance. | |
| - Bone health: Accelerates osteoporosis development, increasing bone vulnerability, especially in postmenopausal women. | |
| Management Considerations | - Patient's age, presence of... |
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