Treatment of subclinical hyperthyroidism in patients older than 50 years: a randomized controlled study

Abstract

Objective: Subclinical hyperthyroidism (SCH) is common and associated with atrial fibrillation (AF) risk in the elderly. Current guidelines rely on a low level of evidence. Methods: Randomized clinical trial including patients 50 years and older, with thyroid-stimulating hormone (TSH) 65 years or TSH < 0.1mU/L. Of 94 patients treated using radioiodine, 25% developed hypothyroidism during follow-up. Conclusion: Due to recruitment difficulties, this study failed to demonstrate that SCH treatment can significantly reduce the incidence of AF in patients older than 50 years with thyroid autonomy even if all the patients who developed AF maintained TSH <0.4 mU/L. This result must be balanced with the increased risk of radioiodine-induced hypothyroidism.

Keywords

• atrial fibrillation
• elderly
• quality of life
• randomized trial
• subclinical hyperthyroidism
• symptoms