Document Detail

Prevalence and causes of undiagnosed hyperthyroidismin an adult healthy population. The Tromsø study.
MedLine Citation:
PMID:  19092288     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The causes of subclinical hyperthyroidism have only been reported from clinical studies.
AIM: To determine the prevalence and pathological causes of reduced serum TSH levels in subjects recruited from an epidemiological survey.
MATERIAL/SUBJECTS AND METHODS: Serum TSH was measured in 7954 subjects in the 5th Tromsø study. Subjects with serum TSH<0.50 mIU/l, not using T4, without a previous diagnosis of thyroid disease, without serious concomitant disease, and younger than 80 yr, were invited for a re-examination. If low serum TSH was persistent, thyroid scintigraphy was performed.
RESULTS: Among the 4962 subjects that met the inclusion criteria, serum TSH was <0.50 mIU/l in 105 subjects. Twelve subjects had a suppressed serum TSH level (<0.05 mIU/l). Two of these were lost to follow-up, 4 had Graves' disease, 4 had adenoma, and 2 had multinodular goiter. In the 93 subjects with serum TSH 0.05-0.5 mIU/l, 55 were re-examined, of whom 35 had normalized their serum TSH level. In the remaining 20 subjects, 1 had Graves' disease, 6 had adenoma (of which 2 were toxic adenomas), 7 had multinodular goiter, and 6 were considered normal. Among the 521 subjects using T4, 70 (13.4%) had a suppressed serum TSH level.
CONCLUSIONS: Most of the subjects with a suppressed serum TSH level will be on T4 medication. Otherwise, if the suppressed serum TSH level is found by chance, this probably represents a clinically important thyroid pathology. Also, in subjects with a persistently low serum TSH level (0.05-0.5 mIU/l) most will have a pathological thyroid scan.
M M Bjørndal; K Sandmo Wilhelmsen; T Lu; R Jorde
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endocrinological investigation     Volume:  31     ISSN:  1720-8386     ISO Abbreviation:  J. Endocrinol. Invest.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-12-18     Completed Date:  2009-02-27     Revised Date:  2012-09-10    
Medline Journal Info:
Nlm Unique ID:  7806594     Medline TA:  J Endocrinol Invest     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  856-60     Citation Subset:  IM    
Institute of Clinical Medicine, University of Tromsø, Norway.
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MeSH Terms
Adenoma / complications
Cohort Studies
Goiter, Nodular / complications
Graves Disease / complications
Health Surveys
Hyperthyroidism / epidemiology*,  etiology,  radionuclide imaging
Middle Aged
Norway / epidemiology
Sodium Pertechnetate Tc 99m / diagnostic use
Thyroid Gland / radionuclide imaging
Thyroid Neoplasms / complications
Thyrotropin / blood*
Thyroxine / therapeutic use
Reg. No./Substance:
23288-60-0/Sodium Pertechnetate Tc 99m; 7488-70-2/Thyroxine; 9002-71-5/Thyrotropin

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