[Thyroid dysfunction in aged persons]

This is a short review about thyroid dysfunction in the elderly. Screening investigations from the United States have shown that nearly every 4th woman above the age of 65 is affected. Therefore a state-of-the-art article about this phenomenon seems justified. Epidemiologic studies show that the pattern of thyroid dysfunction depends on the iodine-nutrient status, thyrotoxicosis being more common in countries with iodine deficiency, overt and subclinical hypothyroidism occurring very frequently in areas with sufficient iodine supplementation. After discussing the state of the art of what is known about physiologic changes induced by age in the hypothalamic-pituitary-thyroid axis, it is pointed out that abnormal values of thyroid function parameters in serum should be further investigated. Symptoms of thyroid dysfunction are very rare and often unspecific. Therefore, laboratory screening in women above the age of 65 seems to be justified. Finally, the differences of treating elderly patients with thyroid dysfunction in comparison to treating young patients is discussed. In this discussion the impact of subclinical disturbances of thyroid dysfunction is included.