Subclinical (latent) hyperthyroidism is a form of hyperthyroidism that produces sparse, very difficult-to-see symptoms. As a result, early diagnosis of the disease is not easy, which can have serious consequences, especially in the elderly, where the disease increases the risk of dementia and cardiovascular death. What are the causes of subclinical hypothyroidism? What is its treatment?

Subclinical (latent, subclinical) hyperthyroidismis a disorder of the thyroid gland in the course of which blood thyrotropin (TSH) levels fall below the normal limit, with normal levels of free thyroxine (fT4) and triiodothyronine (fT3).

Subclinical (latent) hyperthyroidism - causes

Subclinical hyperthyroidism occurs in the initial stage of diseases leading to symptomatic hyperthyroidism - in Graves' disease or in autoimmune or subacute thyroiditis (de Quervaine's disease). It is a group of endogenous hyperactivity (hyperthyroidism will be the result of internal factors).

Subclinical hyperthyroidism may also result from the use of supra-physiological doses of thyroid hormones. Then we are talking about exogenous hyperactivity (hyperactivity resulting from external factors).

Subclinical (latent) thyrotoxicosis - symptoms

Symptoms of subclinical hyperthyroidism are very discreet and difficult to notice, therefore the disease is called hyperthyroidism little symptomatic or poorly symptomatic. However, they may be accompanied by:

  • atrial fibrillation (the risk of atrial fibrillation is highest in patients over 60 years of age with TSH levels lower than 0.1 mU / l);
  • tachycardia - heart rate faster than 100 beats per minute;
  • frequent fractures (as a result of lowering bone mineral density);
  • muscle weakness;
  • psychomotor agitation;
Important

In patients over 55 years of age with endogenous subclinical hyperthyroidism, with TSH levels below 0.4 mU / L and the presence of antibodies to thyroid peroxidase (aTPO), an increased risk of dementia was found in studiesand Alzheimer's disease.

Increased mortality from cardiovascular causes was found in patients over 60 years of age with endogenous subclinical hyperthyroidism.

Subclinical (latent) thyrotoxicosis - diagnosis

In order to diagnose the disease, blood tests should show the decrease in TSH twice, at intervals of several weeks. In addition, it is necessary to determine free thyroxine (fT4), free triiodothyronine (fT3) and antibodies to thyroid peroxidase (aTPO). Blood tests also show a reduction in cholesterol, an increase in the activity of liver and muscle enzymes, and an increase in the concentration of sex hormone binding globulin.

CHECK>>TSH results: thyroid test to determine the level of thyrotropin (TSH)

Your doctor may also order ultrasound examinations of the thyroid gland and isotope tests to diagnose the primary thyroid disease.

During the diagnosis, other causes of decreased TSH concentration should be excluded, such as: extra-thyroid syndrome in patients with severe diseases, the influence of drugs (e.g. dopamine, glucocorticoids, dobutamine), abnormal functioning of the pituitary gland, phase of regression of hyperthyroidism, the first trimester of pregnancy.

Subclinical (latent) thyrotoxicosis - treatment

The goal of therapy is to prevent the disease from developing into overt hyperthyroidism, and to prevent or treat atrial fibrillation and osteoporosis.

In the case of subclinical endogenous hyperthyroidism, treatment is the use of a beta-blocker. If the TSH level is below 0.1 mU / L, treatment as for symptomatic hyperthyroidism is usually recommended.

In patients with nodular goiter who are not expected to have spontaneous remission, radical treatment should be considered, including radioiodine (radioiodine - 131-I) therapy and thyroid surgery.

In patients with exogenous subclinical hyperthyroidism, a reduction in the dose of thyroxine should be considered.

Bibliography: Jastrzębska H.,Subclinical hyperthyroidism - diagnostic and therapeutic aspects , "Diseases of the Heart and Vessels" 2006, vol. 3, no. 3

Hyperthyroidism

Hyperthyroidism is a popular disease whose symptoms can sometimes be difficult to capture. However, if you notice excessive sweating, excessive nervousness, problems falling asleep, rapid weight loss for no reason, a digestive tract disorder - it is worth seeing a doctor. Untreated hyperthyroidism negatively affects the functioning of our body.

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