Diagnosis and treatment of hypothyroidism in the elderly.

Published

Journal Article (Review)

The global population is aging with millions of people today living into their 90 s. Thyroid disease, particularly hypothyroidism, is widespread among all age groups, and it is expected to steadily increase as the population gets older. Clinical diagnosis of hypothyroidism is challenging, as the TSH reference range needs to be evaluated according to age, while evaluation of TSH levels must also take into account body weight and other variants such as polypharmacy, comorbidities, and general health condition. Since thyroid hormone has a potent regulatory effect on cholesterol metabolism, the possibility of thyroid dysfunction should be considered in cases of unexplained dyslipidemia. Once hypothyroidism has been confirmed, treatment requires caution, frequent cardiovascular monitoring, and individualized (precision) medicine. Treatment of subclinical hypothyroidism (SCH) in the elderly should be undertaken with care, guided by age and the degree of SCH: a TSH higher than 10 mU/l seems a reasonable threshold, though it should be regularly re-evaluated, while the LT4 dose needs to be tailored, taking into account the patient's health condition and the potential presence of dyslipidemia as well as other metabolic derangements.

Full Text

Duke Authors

Cited Authors

  • Duntas, LH; Yen, PM

Published Date

  • October 2019

Published In

Volume / Issue

  • 66 / 1

Start / End Page

  • 63 - 69

PubMed ID

  • 31482381

Pubmed Central ID

  • 31482381

Electronic International Standard Serial Number (EISSN)

  • 1559-0100

Digital Object Identifier (DOI)

  • 10.1007/s12020-019-02067-9

Language

  • eng

Conference Location

  • United States