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  • Title: Graves' disease, multinodular goiter and subclinical hyperthyroidism.
    Author: Bel Lassen P, Kyrilli A, Lytrivi M, Corvilain B.
    Journal: Ann Endocrinol (Paris); 2019 Sep; 80(4):240-249. PubMed ID: 31427038.
    Abstract:
    Subclinical hyperthyroidism is a common clinical entity, defined by serum TSH below the reference range, with normal FT4 and FT3 levels in an asymptomatic patient. Whether or not subclinical hyperthyroidism should be treated remains a matter of debate. Cross-sectional and longitudinal population-based studies demonstrate association of subclinical hyperthyroidism with risk of atrial fibrillation and osteoporosis, and with cardiovascular and all-cause mortality. However, there are no randomized clinical trials addressing whether long-term health outcomes are improved by treating subclinical hyperthyroidism; in the absence of evidence one way or the other, it seems appropriate to use decision trees taking account of TSH concentration and presence of risk factors (age>65 years or post-menopause, osteoporosis and cardiac disease).
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