Subclinical Thyroid Dysfunction in the Elderly

ABSTRACT

Subclinical thyroid dysfunction, including both subclinical hyperthyroidism and subclinical hypothyroidism is biochemically defined as an abnormal thyroid-stimulating hormone (TSH) level and thyroid hormone level within its reference range. The prevalence of this condition varies according to the reference range for TSH and geographic or demographic factors, but is common in the elderly and in women. Subclinical thyroid dysfunction has various causes. Thus, careful clinical assessment is needed. Subclinical thyroid dysfunction can be likely to progress to overt thyroid disease and be associated with various health outcomes. However, to date, supporting data are lacking and levels of evidence for the associations are different. Although the management of subclinical thyroid dysfunction is controversial, recommendations are based on the degree to which TSH levels have deviated from normal, age, symptoms, and underlying comorbidities. Further studies are needed to inform how to best care for the elderly with subclinical thyroid dysfunction.