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Hypothyroidism in the older population.

Owain Leng¹, Salman Razvi^2,3

¹1Department of Endocrinology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE1 4LP UK.

Thyroid Research

|February 19, 2019

Summary

This summary is machine-generated.

Treatment for mild subclinical hypothyroidism in older adults may not be beneficial and could cause harm. A higher thyroid-stimulating hormone (TSH) target is recommended for elderly patients, with age-appropriate reference ranges for diagnosis.

Keywords:

Ageing Elderly Hypothyroidism TSH

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Area of Science:

Geriatric Medicine
Endocrinology
Internal Medicine

Background:

Overt and subclinical hypothyroidism are common in older adults.
Thyroid hormone replacement therapy is increasingly prescribed for the elderly.
Evidence suggests treatment of subclinical hypothyroidism may not benefit older individuals.

Purpose of the Study:

To review current literature on hypothyroidism in older individuals.
To assess the risk/benefit of contemporary management of hypothyroidism in the elderly.
To emphasize the need for age-specific diagnostic and treatment strategies.

Main Methods:

Review of current literature on hypothyroidism in older individuals.
Assessment of risk/benefit impact of contemporary management on outcomes.
Emphasis on age-related changes in TSH reference ranges and thyroid hormone requirements.

Main Results:

Prevalence of hypothyroidism and TSH reference ranges increase with age.
Minor TSH elevations in older individuals are not associated with adverse outcomes.
Treatment of mild subclinical hypothyroidism may not improve quality of life or symptoms in the elderly.

Conclusions:

A high threshold for treating mild subclinical hypothyroidism in older people is recommended.
Consideration of age-appropriate TSH reference ranges in diagnosis is crucial.
Further randomized controlled trials are needed to guide management, advocating a conservative approach until then.