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Chapter-041 Subclinical Thyroid Disorders

BOOK TITLE: ESI Manual of Clinical Endocrinology

Author
1. Chowdhury Subhankar
2. Goswami Soumik
ISBN
9789351526476
DOI
10.5005/jp/books/12535_50
Edition
2/e
Publishing Year
2015
Pages
7
Author Affiliations
1. Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India, IPGME & R and SSKM Hospital, Kolkata, West Bengal, India, IPGME and R, Kolkata, West Bengal, India, Institute of Post Graduate Medical Education & Research and SSKM Hospital, Kolkata, West Bengal, India, Institute of Post Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
2. NRS Medical College and Hospital, Kolkata, West Bengal, India, Nilratan Sircar Medical College, Kolkata, West Bengal, India, Nil Ratan Sircar Medical College, Kolkata, West Bengal, India, NRS Medical College, Kolkata, West Bengal, India, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal, India
Chapter keywords
Dyslipidemia, subclinical hypothyroidism, levothyroxine, body mass index, carotid intima-media thickness, atrial arrhythmias

Abstract

Subclinical hypothyroidism is characterized as a serum TSH concentration is above the statistically defined upper limit than the reference range when serum free thyroxine (FT4) concentration is within the reference range and a serum TSH concentration is below in case of subclinical hyperthyroidism. The normal range of serum TSH concentration is 0.45–4.5 mIU/L. The common cause of subclinical hypothyroidism is inadequately treated hypothyroidism on levothyroxine (LT4) supplementation. The patient should be assessed for features of hypothyroidism including fatigue, lethargy, slow mentation and so on. The possible consequences are cardiac dysfunction, elevation in total and low-density lipoprotein (LDL) cholesterol and systemic hypothyroid symptoms. Treatment with LT4 is indicated for patients of subclinical hypothyroidism and its evaluation, management are discussed in this chapter. The common cause for subclinical hyperthyroidism is excess thyroid hormone therapy. Subclinical hyperthyroidism is associated with atrial fibrillation and decreased bone mineral density. Clinical judgment should be exerted keeping the patients preference in mind for the optimal management of subclinical thyroid dysfunction.

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