[Dietary iodine deficiency. Its consequences in the aged]

Area of Science:

• Endocrinology
• Geriatrics
• Public Health

Background:

• Dietary iodine deficiency remains a public health concern in Germany, leading to endemic goiter.
• The elderly population is particularly affected by iodine deficiency and associated thyroid conditions.

Purpose of the Study:

• To assess the prevalence of thyroid abnormalities in elderly individuals with endemic goiter.
• To evaluate the efficacy of levothyroxine treatment in older patients with goiter.
• To investigate the age-related development of autonomously functioning nodules in iodine deficiency goiter.

Main Methods:

• Sonographic examination of the thyroid gland in 581 individuals over 60 years old.
• Assessment of thyroid nodule and cystic lesion prevalence.
• Clinical evaluation of levothyroxine responsiveness in elderly versus younger patients.

Main Results:

• 48.8% of participants over 60 exhibited thyroid gland enlargement.
• Thyroid nodules were found in 101 cases, and cystic lesions in 43.
• Goiter showed reduced responsiveness to levothyroxine in the elderly.

Conclusions:

• Iodine deficiency goiter in the elderly presents unique challenges, including the increased prevalence of autonomously functioning nodules.
• Levothyroxine treatment for goiter in the elderly requires careful individual assessment due to decreased responsiveness.
• Thyroidectomy may be necessary in cases of iodine-induced thyrotoxicosis.