Subclinical Thyroid Disease

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Abstract
Subclinical or "mild" thyroid disease is a common disorder, particularly in middle-aged and elderly individuals.1 Greater sensitivity of assays and more frequent assessment of serum thyroid-stimulating hormone (TSH) levels have resulted in more patients requiring interpretation of abnormal thyroid function test results. However, controversy surrounds the definition, clinical importance, and necessity for prompt diagnosis and treatment of subclinical thyroid disease. Previous review articles2-6 and position statements7,8 differ in their conclusions and recommendations, often a consequence of difficulties in interpreting inadequate and conflicting data. In the midst of this uncertainty, clinicians still desire expert guidance for the diagnosis and management of subclinical thyroid disease.