CoChat
Sign Up
Cited by 91Thyroid Disorders and TreatmentsThyroid and Parathyroid SurgeryThyroid Cancer Diagnosis and Treatment

Hypothyroidism in Patients Older Than 55 Years: An Analysis of the Etiology and Assessment of the Effectiveness of Therapy

Diez, J. J.·2002·The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
DOI 10.1093/gerona/57.5.m315
Open this paper in CoChat — free account

Abstract

BACKGROUND: Several epidemiological studies on the prevalence of hypothyroidism in the elderly have been reported; however, extensive series of elderly patients with thyroid dysfunction have not been studied. Our aim has been to assess the relative frequency of the diverse causes of hypothyroidism in a group of patients older than 55 years and the adequacy of control of thyroid function attained by levothyroxine therapy. METHODS: We performed a descriptive, observational, cross-sectional study in the setting of a hospital endocrinology clinic. From a total of 1581 patients older than 55 who were complaining of a thyroid disorder, we studied a group of 655 patients with hypothyroidism. There were 559 women (85.3%, age 65.01 +/- 7.90 years) and 96 men (14.7%, 65.36 +/- 8.39 years). In every patient, we collected etiology, presence of goiter, time of evolution from diagnosis and from therapy prescription, previous and present treatments, current thyroid functional status (free thyroxine and thyrotropin concentration), adequacy of disease control, and thyroid autoimmune status. RESULTS: The causes of hypothyroidism were as follows: autoimmune thyroiditis, 308 (47.0%); postoperative hypothyroidism, 175 (26.7%); therapy for previous thyrotoxicosis, 63 (9.6%); thyrotropin deficiency, 15 (2.3%); iodine excess, 6 (0.9%); subacute thyroiditis, 2 (0.3%); and unknown etiology, 86 (13.1%) patients. Most patients with autoimmune thyroiditis were positive for thyroid peroxidase antibodies at the time of the study (94.4%). Mean (+/- SD) age at diagnosis was 61.8 +/- 9.4 years in men and 59.8 +/- 9.7 years in women. Median (range) duration of hypothyroidism was 1.4 (0-18) years in men and 3 (0-45) years in women ( p <.05). Adequacy of therapy was studied in 385 patients treated with replacement doses of levothyroxine. Two hundred and sixty (67.5%) of these subjects attained good control, whereas 125 (32.5%) showed inadequate control of the disease at the time of the study. A model of logistic regression showed that adequacy of therapy was dependent on the duration of therapy, but independent of age, gender, degree of hypothyroidism, etiology, autoimmune status, age at diagnosis, and dose of levothyroxine. A 2-year follow-up study performed in 56 newly diagnosed patients showed that an adequate control of hypothyroidism was attained in 35 (62.5%) patients at 6 months, in 46 (82.1%) patients at 1 year, and in 49 (87.5%) at 2 years of therapy with levothyroxine. CONCLUSIONS: Autoimmune thyroiditis and postoperative hypothyroidism are the main causes of thyroid hypofunction in patients older than 55 years. The time from starting therapy is the main determinant of the adequacy of control of thyroid hypofunction in this population. With effective therapy and appropriate monitoring, more than 80% of the patients showed adequate control within 1 year of follow-up.

Integrity signals

Registry

Crossref · 10.1093/gerona/57.5.m315

Cites

34 of 34 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Five to 24 percent of all patients taking L-T4 develop iatrogenic thyrotoxicosis, a proportion that is even higher in the elderly (up to 41%).

    “Five to 24 percent of all patients taking L-T4 develop iatrogenic thyrotoxicosis (9, 11, 78, 81–83), a proportion that is even higher in the elderly [up to 41% (79)].”

    From Levothyroxine therapy in elderly patients with hypothyroidism (2021) · cites this paper as [81]

Cites

Flagged first, then by citations

2 of the 36 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Related

Authors
Diez, J. J.
Venue
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
Publisher
Oxford University Press (OUP)
Published
2002-05-01
Volume
57
Issue
5
Pages
M315-M320
ISSN
  • 1079-5006 (ISSN-L)
  • 1758-535X
DOI
10.1093/gerona/57.5.m315
OpenAlex
W2158652209
Cited by
91
References
36
Citations by year
2025: 2 · 2024: 1 · 2023: 3 · 2022: 8 · 2021: 6 · 2020: 4 · 2019: 3 · 2018: 1 · 2017: 3 · 2016: 7 · 2015: 2 · 2014: 4 · 2013: 2 · 2012: 6
FWCI
3.01
Type
journal article
Language
en
Open access
closed
Locations
  • The Journals of Gerontology Series A (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 › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
Keywords
hypothyroidism, elderly patients, autoimmune thyroiditis, levothyroxine therapy, free thyroxine, thyroid-stimulating hormone, thyroid peroxidase antibodies, postoperative hypothyroidism, goiter, thyroid autoimmunity, treatment duration, sex differences, age differences, iodine excess, subacute thyroiditis
MeSH terms
Cross-Sectional Studies, Female, Follow-Up Studies, Humans, Hypothyroidism, Male, Middle Aged, Thyroid Neoplasms, Thyroidectomy, Thyroiditis, Autoimmune, Thyroxine, Time Factors

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 ›

Are you an author, or do you see a problem with this page? Request a review