Clinical profile and comorbidity patterns in subclinical thyroid disorders

Objectives Subclinical thyroid disorders present a significant challenge in clinical practice due to their subtle presentation and potential health impacts. Their prevalence and clinical manifestations in the North Indian population remain inadequately characterized. The objectives of this study were to analyze the clinical profile, biochemical parameters, and associated comorbidities in patients with subclinical hypothyroidism (SCH) and subclinical hyperthyroidism (SCHyper) at a North Indian tertiary care center. Material and Methods This cross-sectional observational study was conducted at a tertiary care hospital in North India from July 2024 to January 2025. Adult patients diagnosed with SCH and SCHyper based on thyroid function tests were included. Detailed clinical profiles, biochemical parameters, and associated comorbidities were analysed. Results Of 385 patients screened, 68 (17.7%) had SCH and 14 (3.6%) had SCHyper. The mean age was 46.8±12.4 years for SCH and 49.2±13.8 years for SCHyper patients. Female predominance was observed in both groups (SCH: 72.1%, SCHyper: 64.3%). Common symptoms in SCH included fatigue (51.5%), dry skin (69.1%), and cold intolerance (39.7%). SCHyper patients commonly presented with palpitations (42.9%), anxiety (35.7%), and heat intolerance (28.6%). Anti thyroid peroxidase (TPO) antibodies were positive in 45.6% of SCH and 28.6% of SCHyper patients. Significant associations were found between SCH and dyslipidemia (41.2%, p=0.008), obesity (32.4%, p=0.016), and metabolic syndrome (27.9%, p=0.023). SCHyper showed significant associations with anxiety disorders (28.6%, p=0.011), atrial fibrillation (21.4%, p=0.014), and osteoporosis (14.3%, p=0.032). Conclusion Despite being termed “subclinical,” these thyroid disorders present with distinct clinical features and significant comorbidities. The findings suggest that these conditions warrant careful clinical evaluation, particularly for cardiovascular and metabolic risk factors in SCH, and cardiac arrhythmias and bone health in SCHyper.