Abstract

GARCIA DE FRANCISCO, S.; TABOADA TABOADA, M.  and  ALVAREZ VEGA, P.. Subclinical thyroid disfunction. Medifam [online]. 2001, vol.11, n.5, pp.21-38. ISSN 1131-5768.

Recent biochemical advances have led to the development of highly sensitive and less expensive assays of serum thyrotrophin (TSH) and both triyodothyronine (T₃) and free thyroxin (fT₄) for the biochemical assessment of thyroid function. Since TSH is the most sensitive marker of thyroid function, its determination with these new tools makes it possible to detect both subclinical hypo- and hyperthyroidism. Hence, small variations of circulating TSH levels could accurately reflect minor degrees of thyroid disfunction, but clinicians ought to exclude other factors such as acute illnes, drugs or inappropiate thyroid hormone therapy. Bearing this in mind, the clinician should make a individual assesment of every case of thyroid disfunction, and decide hormone therapy accordingly, taking into account the potential risks of iskemic heart disease, osteoporosis, etc., Thus implementing an adecuated long term follows up plan. The management of these patients ouhgt to be allways personalised, considering the risk-benefit ratio, and the general physician should always refer to the specialist endocrinologist any case where thyroid dysfunction could lead to other systemic alterations.

Keywords : Subclinical hypothyroidism; Subclinical hyperthyroidism; Thyrotropin; Thyroxin.

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