{"id":2191,"date":"2018-08-10T21:36:26","date_gmt":"2018-08-10T21:36:26","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/?p=1174"},"modified":"2025-05-13T20:24:31","modified_gmt":"2025-05-13T20:24:31","slug":"subclinical-hyperthyroidism","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/subclinical-hyperthyroidism\/","title":{"rendered":"Diagnosis of Subclinical Hyperthyroidism"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>In overt hyperthyroidism, serum levels of free T4 and triiodothyronine\u00a0(T3) or levels of T3 alone are elevated, and serum thyrotropin (TSH) levels are\u00a0suppressed. In subclinical hyperthyroidism, levels of free T4 and T3 are normal,\u00a0thyrotropin levels are suppressed, and thyroid hormone levels are usually in the\u00a0middle to upper range of normal.<!--more--><br \/>\nThe diagnosis\u00a0of subclinical hyperthyroidism is based on\u00a0laboratory results, but several other common\u00a0clinical situations are associated with similar\u00a0laboratory findings.<\/p>\n<p><strong>Overt primary hyperthyroidism<\/strong><br \/>\nSuppressed thyrotropin levels and elevated levels of free thyroxine (T4) and\u00a0triiodothyronine (T3) or elevated levels of T3 only<\/p>\n<p><strong>Subclinical hyperthyroidism<\/strong><br \/>\nIn mild cases, low but detectable serum thyrotropin levels (0.1 to 0.4 mU per\u00a0liter) with normal levels of free T4 and T3<br \/>\nIn severe cases, undetectable serum thyrotropin level (&lt;0.1 mU per liter) with\u00a0normal levels of free T4 and T3<\/p>\n<p><strong>Other causes of low serum thyrotropin levels<\/strong><br \/>\nThe following causes of low serum thyrotropin levels should be ruled out\u00a0before a diagnosis of subclinical hyperthyroidism is made:<\/p>\n<ol>\n<li>Severe nonthyroidal illness<\/li>\n<li>Administration of drugs that suppress serum thyrotropin levels (e.g.,\u00a0dopamine, high doses of glucocorticoids, dobutamine, somatostatin\u00a0analogues, amphetamines, bromocriptine, and bexarotene)<\/li>\n<li>Pituitary or hypothalamic disease that causes thyroid hormone or thyrotropin deficiency<\/li>\n<li>Psychiatric illness<\/li>\n<li>Late first-trimester of pregnancy<\/li>\n<li>Hyperemesis gravidarum<\/li>\n<li>Older age (i.e., age-induced changes in the hypothalamic\u2013pituitary thyroid axis in areas of the world with iodine deficiency)<\/li>\n<li>African descent (thyrotropin levels are below the reference range in 3 to 4% of patients)<\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p><strong>References:<\/strong><\/p>\n<ol>\n<li>Biondi B, Cooper DS.\u00a0Subclinical Hyperthyroidism.\u00a0N Engl J Med. 2018 Jun 21;378(25):2411-2419. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/29924956\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>De Leo S, Lee SY, Braverman LE. Hyperthyroidism.\u00a0Lancet. 2016 Aug 27;388(10047):906-918. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27038492\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created Aug 07, 2018.<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[153],"tags":[123,13,412,411,410,409,408,407,413],"class_list":["post-2191","post","type-post","status-publish","format-standard","hentry","category-endocrinology-and-metabolism","tag-diagnosis","tag-diagnostico","tag-hipertiroidismo","tag-hyperthyroidism","tag-subclinical","tag-subclinico","tag-t3","tag-t4","tag-tsh"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2191","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2191"}],"version-history":[{"count":3,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2191\/revisions"}],"predecessor-version":[{"id":9226,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2191\/revisions\/9226"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2191"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2191"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2191"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}