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Occult thyroid disease in an elderly hospitalized population
Journal of Gerontology
|May 1, 1978
Summary
Screening hospitalized patients over 60 for thyroid disease is crucial. A serum thyroxine (T4) measurement is the best initial test, with further thyroid-stimulating hormone (TSH) or triiodothyronine (T3) tests as needed.
Area of Science:
- Endocrinology
- Geriatric Medicine
- Clinical Chemistry
Background:
- Thyroid dysfunction is common in the elderly.
- Early detection of thyroid disease in hospitalized older adults is important for management.
Purpose of the Study:
- To evaluate the effectiveness of different thyroid function tests in screening for occult thyroid disease in hospitalized patients over 60 years of age.
Main Methods:
- Measured serum thyroxine (T4), triiodothyronine (T3), thyrotropin (TSH), and T3 talc uptake (T3TU) in 425 patients.
- Analyzed results to identify prevalence of thyroid dysfunction and assess test utility.
Main Results:
- Occult thyroid disease was found in 2.4% of patients (9 hypothyroid, 1 hyperthyroid).
- Low T4 levels were often transient in seriously ill patients.
- TSH was useful for hypothyroidism but not hyperthyroid screening; T4 was the best single screening test.
Conclusions:
- A serum T4 measurement is recommended for all hospitalized patients over 60.
- Follow-up TSH or T3/T3TU tests can confirm diagnoses based on initial T4 results.