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Related Experiment Videos

Thyrotoxicosis in the very old.

J M Tibaldi, U S Barzel, J Albin

    The American Journal of Medicine
    |October 1, 1986
    PubMed
    Summary
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    Thyroid disease after the sixth decade.

    Current therapy in endocrinology and metabolism·1997

    Hyperthyroidism in the elderly often presents with subtle symptoms, making diagnosis challenging. Regular thyroid function tests are recommended for individuals over 75 to ensure early detection and management of thyroid disease.

    Area of Science:

    • Endocrinology
    • Geriatric Medicine
    • Internal Medicine

    Background:

    • Hyperthyroidism, or overactive thyroid, affects individuals of all ages.
    • The elderly population often exhibits atypical or subtle symptoms of hyperthyroidism.
    • Early diagnosis and management of hyperthyroidism are crucial for preventing complications.

    Purpose of the Study:

    • To review the clinical presentation and diagnostic findings of hyperthyroidism in patients over 75 years of age.
    • To assess the correlation between clinical signs, symptoms, and laboratory values in this age group.
    • To emphasize the importance of screening for thyroid dysfunction in the elderly.

    Main Methods:

    • Retrospective review of medical records for 25 patients aged 75 and older diagnosed with hyperthyroidism.

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  • Analysis of presenting symptoms, clinical signs, thyroid function tests (thyroxine, triiodothyronine), and radioiodine uptake.
  • Evaluation of common causes including Graves' disease, multinodular goiter, and toxic adenoma.

    • Main Results:

    • The mean age was 81.5 years; 22 patients were female. Graves' disease was the most common diagnosis (21 patients).
    • Common symptoms included weight loss, palpitations, and weakness, with an average of only two symptoms per patient. Two patients were asymptomatic.
    • Subtle clinical signs like fine skin, tremor, atrial fibrillation, and tachycardia were noted. Thyroid palpation was infrequent. Hormone levels and radioiodine uptake showed variability, with some patients having normal results.

    Conclusions:

    • Hyperthyroidism in very elderly individuals may present with non-specific or absent symptoms and signs, complicating clinical diagnosis.
    • The subtle presentation necessitates a high index of suspicion and regular screening of thyroid hormone levels in elderly patients.
    • Periodic screening of blood thyroxine levels is recommended for all elderly subjects to facilitate early diagnosis of thyroid disease.