Case studies

A postmenopausal woman with subclinical hyperthyroidism

Albert Hsieh, Elizabeth L Chua



Untreated subclinical hyperthyroidism may lead to significant cardiovascular and musculoskeletal complications. Investigations such as thyroid scintigraphy and thyroid antibody status will help define the underlying aetiology so treatment can be targeted.

Key Points

  • Subclinical hyperthyroidism is defined as persistently suppressed thyroid-stimulating hormone levels with normal free thyroxine and free triiodothyronine levels.
  • The most common cause of subclinical hyperthyroidism in people over 65 years of age is toxic multinodular goitre.
  • Subclinical hyperthyroidism can lead to cardiovascular, musculoskeletal and neurological complications.
  • All individuals over 65 years of age with subclinical hyperthyroidism should be considered for treatment.