Jacobs Journal of Internal Medicine

Subclinical Hyperthyroidism: Clinical Consequences and Management

Published on: 2016-08-04


Background: Subclinical hyperthyroidism (Shyper) is a common clinical entity which represents a condition of mild thyroid over-activity. Whether or not Shyper should be treated remains a matter of debate, despite the body of evidence that demonstrates an association between this condition and significant adverse effects.
Summary: After an overview of the etiology, differential diagnosis, epidemiology and natural history of Shyper, this review will focus on the clinical outcomes related to this condition, i.e., cardiovascular morbidity and mortality, bone health, mood and cognitive function. The treatment options of Shyper are essentially the same as overt hyperthyroidism. Notwithstanding the lack of appropriately designed prospective studies, we provide a practical framework to effectively manage Shyper.
Conclusion: Treatment of Shyper should be considered after evaluating four critical parameters: age>65 years, the degree of TSH suppression (TSH <0.1mU/L), the presence of clinical thyroid abnormalities and underlying relevant co-morbidities.


Subclinical hyperthyroidism; Treatment; Cardiovascular risk; Atrial fibrillation; Osteoporosis