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Thyroid status in elderly sick patients.

N Demeester-Mirkine, M Kutnowski, B Futeral

    Journal of Endocrinological Investigation
    |January 1, 1981
    PubMed
    Summary
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    Thyroid function tests revealed subtle abnormalities in euthyroid patients over 75 years old, particularly in their response to TRH stimulation and circulating thyroid hormone levels.

    Area of Science:

    • Endocrinology
    • Geriatric Medicine
    • Thyroidology

    Background:

    • Euthyroid sick syndrome can present with altered thyroid hormone levels in hospitalized patients.
    • Age-related changes in thyroid function require careful evaluation, especially in older adults.

    Purpose of the Study:

    • To investigate thyroid function in euthyroid patients hospitalized for chronic disease or recovering from acute illness.
    • To identify age-specific thyroid function abnormalities in elderly euthyroid individuals.

    Main Methods:

    • Thyroid investigations including TRH tests and measurement of circulating thyroid hormones (TSH, T3, reverse T3, free T4 index) were performed.
    • Patients were stratified into three age groups, with a focus on those over 75 years.

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    Main Results:

    • Abnormalities were exclusively observed in patients over 75 years.
    • These included a blunted and delayed TSH response to TRH (delta TSHmax) with maintained T3 increase (delta T3), and altered circulating thyronine patterns (increased reverse T3, normal/decreased T3).
    • Three cases showed an elevated free T4 index.

    Conclusions:

    • Euthyroid elderly patients hospitalized for illness may exhibit distinct thyroid function test patterns.
    • These specific alterations in TRH response and thyronine profiles can help differentiate them from hyperthyroid states.