Subclinical Hyperthyroidism
A 55-year-old postmenopausal woman has a persistently suppressed TSH of 0.08 mU/L on two occasions. FT4 and FT3 are both normal. She is entirely asymptomatic. Which of the following is the most significant long-term risk associated with her untreated condition?
Correct Answer — B
Subclinical hyperthyroidism (suppressed TSH, normal FT4/FT3) carries two well-evidenced long-term risks: atrial fibrillation (especially in patients over 60) and decreased bone mineral density (especially in postmenopausal women). The excess TSH suppression — even without overt hormone elevation — is sufficient to increase cardiac and skeletal risk over time. This patient fits both risk profiles: postmenopausal and likely over 50.
Key concept
Subclinical hyperthyroidism key risks: AF (especially >60 years) and osteoporosis (especially postmenopausal women).