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Subclinical thyroid disorders: significance and clinical impact
  1. Salman Razvi1,2,
  2. Jolanta U Weaver1,3,
  3. Simon H S Pearce2,4
  1. 1Department of Endocrinology, Gateshead Health NHS Foundation Trust, Gateshead, UK
  2. 2Institute of Human Genetics, Newcastle University, Newcastle upon Tyne, UK
  3. 3Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
  4. 4Endocrine Unit, Royal Victoria Infirmary, Newcastle upon Tyne, UK
  1. Correspondence to Salman Razvi, Queen Elizabeth Hospital, Gateshead NE9 6SX, UK; salman.razvi{at}


Subclinical thyroid diseases are defined by abnormal serum thyroid stimulating hormone (TSH) levels associated with normal thyroid hormone concentrations. The diagnosis of these conditions depends on defining the ‘normal’ euthyroid TSH range; in this review, arguments for and against lowering the upper limit of TSH are summarised. Although, subclinical hypothyroidism and subclinical hyperthyroidism are frequently encountered, their long-term consequences are debated due to conflicting results from many observational studies. The causes, effects and outcomes of treatment of both subclinical diseases are described, and the direction of future research in these conditions is outlined.

  • Effects of treatment
  • subclinical hyperthyroidism
  • subclinical hypothyroidism
  • thyroid
  • TSH reference range

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  • Competing interests None.

  • Provenance and peer review Commissioned; externally peer reviewed.