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[Hypothyroidism in the elderly--a concealed disease].

P Wahlberg

    Nordisk Medicin
    |January 1, 1989
    PubMed
    Summary

    Hypothyroidism in older adults often presents subtly, mimicking other conditions. Early screening with serum TSH is recommended, with cautious thyroxine replacement therapy and observation for subclinical cases.

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    Area of Science:

    • Geriatric Medicine
    • Endocrinology
    • Internal Medicine

    Context:

    • Hypothyroidism in the elderly often presents atypically, with symptoms easily mistaken for arteriosclerotic disease.
    • The insidious onset of geriatric hypothyroidism necessitates a high index of suspicion.
    • Current diagnostic and management strategies require adaptation for the aging population.

    Purpose:

    • To highlight the atypical presentation of hypothyroidism in the elderly.
    • To advocate for systematic screening of hypothyroidism in older individuals.
    • To provide guidance on cautious thyroxine replacement and monitoring.

    Summary:

    • Screening for hypothyroidism in the elderly is recommended, utilizing serum TSH as the primary diagnostic tool.
    • Thyroxine substitution therapy should be initiated at very low doses and carefully titrated.
    • Asymptomatic individuals with subclinical hypothyroidism require ongoing observation for symptom development.

    Impact:

    • Improved early detection of hypothyroidism in the elderly population.
    • Reduced misdiagnosis of hypothyroidism as arteriosclerotic disease.
    • Safer and more effective management of thyroid dysfunction in older adults.

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