Thyroid status in elderly sick patients

Thyroid investigations were performed on 55 euthyroid patients hospitalized for chronic disease or recovering from acute illness. Three age groups were considered. Abnormalities were found only in patients over 75 years: 1) in the TRH test the maximum increase in serum TSH (delta TSHmax) was less marked and frequently delayed to 60 min, whereas the increase in T3 in 120 min (delta T3) was maintained; basal TSH was normal; 2) in 15 out of 28 cases, the pattern of circulating thyronines was abnormal showing an increase in reverse T3 a normal or decreased T3, and a rise in free T4 index beyond the normal range in 3 cases. In all cases but one, the combination of delta TSHmax, and delta T3 differentiated these patients from hyperthyroids.