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Subklinisk hypertyreose

Sist oppdatert: Sist revidert:
Sist revidert av:
Definisjon:
Defineres som TSH under referanseområdet (< 0,5 mIE/L), normal tyroksin (T4) og trijodtyronin (T3)
Forekomst:
Prevalens synes å være under 1%
Symptomer:
Selv om tilstanden per definisjon er uten symptomer, så kan vage symptomer og tegn på tyreotoksikose forekomme
Funn:
Kliniske funn som regel normale, men se etter struma
Diagnostikk:
TSH, FT3, FT4 og tyreoideaantistoffer
Behandling:
Behandlingsindikasjonene er uklare
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  3. Surks MI, Ortiz E, Daniels GH, et al. Subclinical Thyroid Disease. Scientific Review and Guidelines for Diagnosis and Management. JAMA 2004; 291: 228-38. Journal of the American Medical Association  
  4. Bjøro T, Holmen H, Krüger Ø, Midthjell K, Hunstad K, Schreiner T et al. Prevalence of thyroid disease, thyroid dysfunction and thyroid peroxidase antibodies in a large, unselected population. The Health Study of Nord-Trøndelag (HUNT). Eur J Endocrinol 2000; 143: 639-47. PubMed  
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  7. Helfand M. Screening for subclinical thyroid dysfunction in nonpregnant adults: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2004; 140: 128-41. Annals of Internal Medicine  
  8. Taylor PN, Iqbal A, Minassian C, et al. Falling threshold for treatment of borderline elevated thyrotropin levels-balancing benefits and risks: evidence from a large community-based study.. JAMA Intern Med 2014; 174: 32-9. pmid:24100714 PubMed  
  9. Medibas. Subklinisk hypertyreos. Stockholm: Medibas; 2017. Sist oppdatert 05.11.2017; sitert 19.03.2018
  10. Babovic A, Müller C, Bach-Gansmo T. Når er det indikasjon for thyreoideascintigrafi?. Tidsskr Nor Legeforen 2013; 133: 937. pmid:23652138 PubMed  
  11. Bauer DC, Ettinger B, Nevitt MC, Stone KL, for the Study of Osteoporotic Fractures Research Group. Risk for fracture in women with low serum levels of thyroid-stimulating hormone. Ann Intern Med 2001; 134: 561-8. Annals of Internal Medicine  
  12. Biondi B, Bartalena L, Cooper DS et al. The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism. Eur Thyroid J. 2015 Sep;4(3):149-63. PMID: 26558232 PubMed  
  13. Donangelo I, Suh SY. Subclinical Hyperthyroidism: When to Consider Treatment. Am Fam Phys 2017; 95: 710-16. pmid:28671443 PubMed  
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  16. Wiersinga WM. Subclinical hypothyroidism and hyperthyroidism. I. Prevalence and clinical relevance. Neth J Med 1995; 46: 197-204. PubMed  
  17. Cappola AR, Fried LP, Arnold AM, et al. Thyroid status, cardiovascular risk, and mortality in older adults. JAMA 2006; 295: 1033-41. PubMed  
  18. Baumgartner C, da Costa BR, Collet TH, et al. Thyroid Function Within the Normal Range, Subclinical Hypothyroidism, and the Risk of Atrial Fibrillation. Circulation 2017; 136: 2100. pmid:29061566 PubMed  
  19. Collet T-H, Gussekloo J, Bauer DC, et al. Subclinical hyperthyroidism and the risk of coronary heart disease and mortality. Arch Intern Med 2012; : doi:10/1001/archinternmed.2012.402.
  20. Gencer B, Collet TH, Virgini V, et al. Subclinical thyroid dysfunction and the risk of heart failure events: an individual participant data analysis from 6 prospective cohorts. Circulation 2012; 126: 1040-9. Circulation  
  21. Blum MR, Bauer DC, Collet T-H, et al. Subclinical thyroid dysfunction and fracture risk. A meta-analysis. JAMA 2015; 313: 2055-65. doi:10.1001/jama.2015.5161 DOI  
  22. van Vliet NA, Van Heemst D, Almeida Op, Åsvold BO, et al. Association of thyroid dysfunction with cognitive function: An individual participant data analysis. JAMA Intern Med 2021. PMID: 34491268 PubMed  
  23. Aubert CE, Bauer DC, da Costa BR, et al. The association between subclinical thyroid dysfunction and dementia: The Health, Aging and Body Composition (Health ABC) Study. Clin Endocrinol (Oxf) 2017; 87: 617. pmid:28850708 PubMed  
  24. Sun J, Yao L, Fang Y, et al. Relationship between Subclinical Thyroid Dysfunction and the Risk of Cardiovascular Outcomes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. Int J Endocrinol 2017. pmid:29081800 PubMed  
  • Ingard Løge, spesialist allmennmedisin, redaktør NEL

Tidligere fagmedarbeidere

  • Ingrid Norheim, overlege, dr. med., seksjonsleder Avdeling for endokrinologi, sykelig overvekt og forebyggende medisin, Oslo Universitetssykehus
  • Stein Vaaler, overlege dr. med., Senter for Klinisk Epidemiologi, Rikshospitalet, Universitetet i Oslo