As we delve into the intricacies of human disease, millions of people continue to be diagnosed as having what are labelled as pre-conditions or sub-clinical entities and may receive treatments designed to prevent further progression to clinical disease, but with debatable impact and consequences. Endocrinology is no different, with almost every organ system and associated diseases having subclinical entities. Although the expansion of these “grey” pre-conditions and their treatments come with a better understanding of pathophysiologic processes, they also entail financial costs and drug adverse-effects, and lack true prevention, thus refuting the very foundation of Medicine laid by Hippocrates “Primum non nocere” (Latin), i.e., do no harm. Subclinical hypothyroidism, prediabetes, osteopenia, and minimal autonomous cortisol excess are some of the endocrine pre-clinical conditions which do not require active pharmacological management in the vast majority. In fact, progression to clinical disease is seen in only a small minority with reversal to normality in most. Giving drugs also does not lead to true prevention by changing the course of future disease. The goal of the medical fraternity thus as a whole should be to bring this large chunk of humanity out of the hospitals towards leading a healthy lifestyle and away from the label of a medical disease condition.
展开▼
机译：随着我们深入研究人类疾病的复杂性，数百万人继续被诊断出患有被标记为先兆病或亚临床疾病的疾病，并可能接受旨在防止进一步发展为临床疾病的治疗，但其影响和后果值得商榷。内分泌学也不例外，几乎每个器官系统和相关疾病都有亚临床实体。尽管这些“灰色”先决条件及其治疗的扩展伴随着对病理生理过程的更好理解，但它们也带来了经济成本和药物不良反应，并且缺乏真正的预防，从而驳斥了希波克拉底奠定的医学基础“Primum non nocere”（拉丁语），即不造成伤害。亚临床甲状腺功能减退症、糖尿病前期、骨质减少和轻微自主皮质醇过量是绝大多数不需要积极药物治疗的一些内分泌临床前疾病。事实上，只有少数人会进展为临床疾病，大多数情况下会恢复正常。给药也不会通过改变未来疾病的进程来真正预防。因此，医学兄弟会作为一个整体的目标应该是将这一大批人带出医院，过上健康的生活方式，远离医学疾病的标签。
展开▼
