According to the American Thyroid Association, which patients with subclinical hyperthyroidism should be treated?

According to the American Thyroid Association, which patients with subclinical hyperthyroidism should be treated?

• A. Over age 65 or TSH <0.1 U/mL
• B. Under age 65 or TSH 0.1-0.5
• C. All patients with subclinical hyperthyroidism
• D. None treated unless symptomatic

Answer: (A)

In subclinical hyperthyroidism, the main concern is who is at higher risk for complications from low TSH, such as atrial fibrillation and bone loss. The American Thyroid Association endorses treating patients who are older than 65 or whose TSH is suppressed to less than 0.1 mIU/L because these factors identify those at higher risk of adverse outcomes. Treating these patients aims to reduce the chances of developing atrial fibrillation, fractures, and progression to overt thyrotoxicosis. Younger patients with only mild TSH suppression (for example, 0.1–0.5 mIU/L) may be monitored unless other risk factors or symptoms prompt treatment. Therefore, the recommended target group for treatment includes those over 65 or with TSH <0.1 mIU/L.

In subclinical hyperthyroidism, the main concern is who is at higher risk for complications from low TSH, such as atrial fibrillation and bone loss. The American Thyroid Association endorses treating patients who are older than 65 or whose TSH is suppressed to less than 0.1 mIU/L because these factors identify those at higher risk of adverse outcomes. Treating these patients aims to reduce the chances of developing atrial fibrillation, fractures, and progression to overt thyrotoxicosis. Younger patients with only mild TSH suppression (for example, 0.1–0.5 mIU/L) may be monitored unless other risk factors or symptoms prompt treatment. Therefore, the recommended target group for treatment includes those over 65 or with TSH <0.1 mIU/L.