The Aging Thyroid: The Use of Thyroid Hormone in Older Persons
Abstract
The overall prevalence of thyroid hormone use in an unselected population of older adults (n = 2575; average age, 68.6 years) was 6.9% (10.0% in women and 2.3% in men). Eighty-one percent of women taking it were doing so for appropriate indications, eg, hypothyroidism, while 12% were not, eg, for obesity or high serum cholesterol; more men (29%) were taking it inappropriately. Inappropriate use was associated with desiccated thyroid more than with thyroxine. After follow-up averaging 6.9 years, 58% of inappropriate users were still taking it. Underuse also occurred. Thirty-seven percent of those definitely hypothyroid had a clearly elevated serum thyrotropin level (greater than 10 mU/L) despite thyroid therapy. Thyroid therapy is common in the elderly; most is appropriate. When inappropriate use occurs, it is more common in men and more often associated with desiccated thyroid, still commonly used in this age group. In chronic users of thyroid hormone, it is important to review currently appropriate indications and to measure serum thyrotropin levels to assess the adequacy of treatment of primary hypothyroidism.
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As levothyroxine requirements decrease with age, iatrogenic hyperthyroidism is more common in older people.
“As levothyroxine requirements decrease with age, iatrogenic hyperthyroidism is more common in older people.3 5”
From Levothyroxine dose and risk of fractures in older adults: nested case-control study (2011) · cites this paper as [5]
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- Authors
- Sawin, C. T.
- Affiliations
- United States Department of Veterans Affairs (US)
- Corresponding author
- Sawin, Clark T.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 1989-05-12
- Volume
- 261
- Issue
- 18
- Pages
- 2653
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2043303113
- Cited by
- 94
- References
- 16
- Citations by year
- 2023: 2 · 2021: 1 · 2019: 2 · 2017: 2 · 2016: 5 · 2015: 5 · 2014: 2 · 2013: 3 · 2012: 4
- FWCI
- 3.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- thyroid hormone replacement, older adults, hypothyroidism, inappropriate prescribing, desiccated thyroid, levothyroxine, serum thyrotropin, sex differences in prescribing
- MeSH terms
- Age Factors, Aged, Drug Utilization, Female, Follow-Up Studies, Goiter, Humans, Hypercholesterolemia, Hypothyroidism, Male, Sex Factors, Thyroid Diseases, Thyroid Hormones, Cohort Studies
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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