Hypothyroidism in elderly, the problem of diagnosis and treatment, part 1
Contributor: Anna Ilyushchenko
Affiliation: Second-year resident Russian Gerontology Research and Clinical Centre, Moscow
Hi everyone! My name is Ann. I'm a new member of this science community. I'm a second-year resident. I'm taking postgraduate a course at Russian gerontological scientific-clininal centre in Moscow.
I'm particularly interested in general issues of endocrinology and gerontology. I'd like to begin a series of articles about diagnosis and therapy of hypothyroidism and subclinical hypothyroidism at older ages.
Thyroid is a vital organ. It plays an important role in the metabolism and development of the human body by releasing a steady amount of thyroid hormones into the blood. Thyroid hormones influence an important metabolic function across adulthood and in the aging phases. Thyroid hormones are involved in the regulation of the oxygen consumption and heat production. They are necessary for a correct protein synthesis, modulate the adrenergic system activity.
With age its functional activity changes. And it becomes difficult to realise if it's normal or if it's pathology.
Hypothyroidism is a clinical syndrome when the thyroid gland does not produce enough thyroid hormones. Hypothyroidism makes people feel tired, depressed, gain weight be unable to tolerate cold temperatures.
Subclinical hypothyroidism is an early mild form of hypothyroidism. It's called subclinical because only the serum level of thyroid-stimulating hormone (TSH) is a little bit above normal. In the elderly subclinical hypothyroidism occurs more often. It accounts for 3-16% over the age of 60.
Often signs of hypothyroidism con be seen by doctors as normal aging of the human body. Indeed, such symptoms as dry skin, alopecia, loss of appetite, weakness, cognitive limitations and dementia are similar to normal aging. The choice of treatment should depend on the presence of clinical signs consistent with hypothyroidism. We have to be extremely cautious in treating older patients.
There are many difficulties and special aspects in this theme. I will continue to tell you about hypothyroidism in the next article
Valeria Calsolaro, Filippo Niccolai, Giuseppe Pasqualetti, Sara Tognini, Silvia Magno, Tommaso Riccioni, Marina Bottari, Nadia Caraccio, Fabio Monzani, Hypothyroidism in the Elderly: Who Should Be Treated and How?, Journal of the Endocrine Society, Volume 3, Issue 1, January 2019, Pages 146–158, https://doi.org/10.1210/js.2018-00207
Leng, O., Razvi, S. Hypothyroidism in the older population. Thyroid Res 12, 2 (2019). https://doi.org/10.1186/s13044-019-0063-3