Subklinische Hyperthyreose

Zusammenfassung

Die subklinische Hyperthyreose ist definiert durch ein erniedrigtes TSH bei normalen Schilddrüsenhormonwerten. Diese Laborkonstellation wird bei einem Teil der Patienten symptomatisch mit Tachykardie, erhöhter Schweißneigung, Ängstlichkeit, Nervosität, Schlaflosigkeit und weiteren Zeichen. Das Risiko für kardiovaskuläre Erkrankungen ist erhöht mit einer höheren Frequenz für Vorhofflimmern und einer Zunahme der linksventrikulären Masse. Die kardiovaskuläre und die Gesamtsterblichkeit sind höher als in der Normalbevölkerung. Eine lang andauernde TSH-Suppression führt zu einer Knochendichteerniedrigung und zu erhöhter Frakturgefahr im Bereich von Wirbelsäule und Hüfte. Eine Therapie sollte zumindest bei TSH-Werten unter 0,1 mIU/l nach Abklärung der Ursachen erwogen werden.

Abstract

Subclinical hyperthyroidism is defined as abnormal low TSH level with thyroid hormones within their reference range. This laboratory condition may be symptomatic in a relevant number of patients leading to tachycardia, sweating, nervousness, anxiety and insomnia. The risk for cardiovascular disease is increased with more frequent atrial fibrillation and increased left ventricular mass including diastolic dysfunction. Cardivascular mortality and overall mortality surmounts the average of the normal population. Longterm TSH suppresion leads to decreased bone mineral density and an increased fracture rate in the hip and in the spine. After evaluation of underlying causes, therapy should be considered, especially if TSH levels are below 0.1 mIU/l.

Schlüsselwörter

TSH-Suppression - kardiovaskuläre Effekte - Knochendichte - Mortalität

Keywords

TSH-Suppression - cardiovascular effects - bone mineral density - mortality

• Literatur

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