Thyroid Hormone Concentrations, Disease, Physical Function, and Mortality in Elderly Men
Open accessAbstract
CONTEXT: Physiological changes in thyroid hormone concentrations might be related to changes in the overall physical function in the elderly. OBJECTIVE: We determined to what extent thyroid hormone concentrations are related to physical function and mortality in elderly men. DESIGN: A longitudinal population study (the Zoetermeer study) was conducted. Mortality was registered in the subsequent 4 yr. PARTICIPANTS: Four hundred three independently and ambulatory living men (aged 73-94 yr) participated. MAIN OUTCOME MEASURES: The study examined the association between serum thyroid hormones and parameters of physical function as well as the association with mortality. METHODS: TSH, free T4 (FT4) total T4, T3, rT3, and T4-binding globulin were measured. Physical function was estimated by the number of problems in activities of daily living, a measure of physical performance score (PPS), leg extensor strength and grip strength, bone density, and body composition. RESULTS: Serum rT3 increased significantly with age and the presence of disease. Sixty-three men met the biochemical criteria for the low T3 syndrome (decreased serum T3 and increased serum rT3). This was associated with a lower PPS, independent of disease. Furthermore, higher serum FT4 (within the normal range of healthy adults) and rT3 (above the normal range of healthy adults) were related with a lower grip strength and PPS, independent of age and disease. Isolated low T3 was associated with a better PPS and a higher lean body mass. Low FT4 was related to a decreased risk of 4-yr mortality. CONCLUSIONS: In a population of independently living elderly men, higher FT4 and rT3 concentrations are associated with a lower physical function. High serum rT3 may result from a decreased peripheral metabolism of thyroid hormones due to the aging process itself and/or disease and may reflect a catabolic state. Low serum FT4 is associated with a better 4-yr survival; this may reflect an adaptive mechanism to prevent excessive catabolism.
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Longevity was associated with higher TSH concentrations in the Ashkenazi population and confirmed by two Dutch studies.
“Longevity was associated with higher TSH concentrations in the Ashkenazi population (19) and confirmed by two Dutch studies (the Leiden 85-Plus Study and the Leiden Longevity Study) (33–35).”
From Levothyroxine therapy in elderly patients with hypothyroidism (2021) · cites this paper as [35]
There are some differences between men and women in the association between T3/fT3 and muscle mass.
“Nevertheless, data on the association between T3/fT3 and muscle mass are conflicting and some studies found negative (35, 123), while others positive associations (124–126), with some differences between men and women.”
From Levothyroxine therapy in elderly patients with hypothyroidism (2021) · cites this paper as [35]
Some studies found negative associations between T3/fT3 and muscle mass.
“Nevertheless, data on the association between T3/fT3 and muscle mass are conflicting and some studies found negative (35, 123), while others positive associations (124–126), with some differences between men and women.”
From Levothyroxine therapy in elderly patients with hypothyroidism (2021) · cites this paper as [35]
Data on the association between T3/fT3 and muscle mass are conflicting.
“Nevertheless, data on the association between T3/fT3 and muscle mass are conflicting and some studies found negative (35, 123), while others positive associations (124–126), with some differences between men and women.”
From Levothyroxine therapy in elderly patients with hypothyroidism (2021) · cites this paper as [35]
Not all studies have confirmed age-related TSH elevations; studies from Holland, India, Germany, China, Italy, and the UK Whickham community survey failed to show TSH elevations with age.
“However, not all studies have confirmed these changes. Studies from Holland [89], India [90], Germany [91], China [92] as well as older data from Italy [93] and the UK Whickham community survey failed to show TSH elevations with age.”
From Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice (2023) · cites this paper as [89]
A study in elderly Dutch men showed no age-related changes in TSH and FT4 but reported lower FT3 levels together with an increase in reverse T3 (rT3) with age.
“A study in elderly Dutch men showed no age-related changes in TSH and FT4 but reported lower FT3 levels together with an increase in reverse T3 (rT3) with age [89].”
From Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice (2023) · cites this paper as [89]
Scant data exist about the relationship between thyroid function, functional status, and future disability in this age group.
“Scant data exist about the relationship between thyroid function, functional status, and future disability in this age group (43, 46, 47).”
From Serum Thyroid Function, Mortality and Disability in Advanced Old Age: The Newcastle 85+ Study (2016) · cites this paper as [43]
A longitudinal study of 403 Dutch males age 73-94 years found that a group with higher rT3 but normal FT3 had better performance status than those with lower FT3.
“This finding is consistent with a longitudinal study of 403 Dutch males age 73–94 years in which a group with higher rT3 but normal FT3 had better performance status than those with lower FT3 (43).”
From Serum Thyroid Function, Mortality and Disability in Advanced Old Age: The Newcastle 85+ Study (2016) · cites this paper as [43]
Reduced circulating concentration of free T3 is a sensitive marker of ill health.
“Reduced circulating concentration of free T3 is a sensitive marker of ill health (43).”
From Serum Thyroid Function, Mortality and Disability in Advanced Old Age: The Newcastle 85+ Study (2016) · cites this paper as [43]
Endogenous subclinical hyperthyroidism, in contrast to exogenous LT4 suppressive therapy, may induce long-term alterations in energy expenditure and body composition.
“These studies suggest that endogenous subclinical hyperthyroidism, in contrast to exogenous LT4 suppressive therapy, may induce long-term alterations in energy expenditure and body composition.”
From Effects of levothyroxine replacement or suppressive therapy on energy expenditure and body composition (2016) · cites this paper as [18]
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- Authors
- van den Beld, A. W., Visser, T. J., Feelders, R. A., Grobbee, D. E., & Lamberts, S. W. J.
- Affiliations
- Department of Internal Medicine (A.W.v.d.B., T.J.V., R.A.F., S.W.J.L.), Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands;
- Erasmus MC (NL)
- University Medical Center Utrecht (NL)
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2005-12-01
- Volume
- 90
- Issue
- 12
- Pages
- 6403-6409
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2144289508
- Cited by
- 294
- References
- 21
- Citations by year
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- FWCI
- 5.54
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Funders
- Erasmus Medisch Centrum
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Keywords
- thyroid hormones, older men, physical function, mortality, reverse T3, free thyroxine, low T3 syndrome, grip strength, activities of daily living, aging, catabolism, lean body mass, thyroid-stimulating hormone, T4-binding globulin
- MeSH terms
- Activities of Daily Living, Aged, Aging, Body Composition, Cross-Sectional Studies, Humans, Hyperthyroidism, Hypothyroidism, Leg, Male, Osmolar Concentration, Physical Fitness, Thyroid Hormones, Bone Density, Muscle, Skeletal, Hand Strength
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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