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Cited by 139Thyroid Disorders and TreatmentsThyroid and Parathyroid SurgeryThyroid Cancer Diagnosis and Treatment

Hypothyroidism in the elderly: diagnosis and management

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Bensenor, Isabela, Lotufo, Paulo, Diaz-Olmos·2012·Clinical Interventions in Aging
DOI 10.2147/cia.s23966PMC PMC3340110
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Abstract

Hypothyroidism in the elderly: diagnosis and management Isabela M Bensenor1,2, Rodrigo D Olmos1,2, Paulo A Lotufo1,21Division of Internal Medicine, Hospital Universitário, University of São Paulo, São Paulo, Brazil; 2Department of Internal Medicine, School of Medicine, University of São Paulo, São Paulo, BrazilAbstract: Thyroid disorders are highly prevalent, occurring most frequently in aging women. Thyroid-associated symptoms are very similar to symptoms of the aging process; thus, improved methods for diagnosing overt and subclinical hypothyroidism in elderly people are crucial. Thyrotropin measurement is considered to be the main test for detecting hypothyroidism. Combined evaluations of thyroid stimulating hormone (TSH) and free-thyroxine can detect overt hypothyroidism (high TSH with low free-thyroxine levels) and subclinical hypothyroidism (high TSH with normal free-thyroxine levels). It is difficult to confirm the diagnosis of thyroid diseases based only on symptoms, but presence of symptoms could be an indicator of who should be evaluated for thyroid function. The most important reasons to treat overt hypothyroidism are to relieve symptoms and avoid progression to myxedema. Overt hypothyroidism is classically treated using L-thyroxine; elderly patients require a low initial dose that is increased every 4 to 6 weeks until normalization of TSH levels. After stabilization, TSH levels are monitored yearly. There is no doubt about the indication for treatment of overt hypothyroidism, but indications for treatment of subclinical disease are controversial. Although treatment of subclinical hypothyroidism may result in lipid profile improvement, there is no evidence that this improvement is associated with decreased cardiovascular or all-cause mortality in elderly patients. In patients with a high risk of progression from subclinical to overt disease, close monitoring of thyroid function could be the best option.Keywords: overt hypothyroidism, subclinical hypothyroidism, diagnosis, treatment, elderly

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  • The prevalence of hypothyroidism increases with age, and subclinical hypothyroidism affects up to 15% of adults aged 65 years or older when non-age-specific TSH reference ranges are used.

    “The prevalence of hypothyroidism increases with age and subclinical hypothyroidism affects up to 15% of adults 65 years of age or older, when non-age-specific TSH reference ranges are used (9, 12–14).”

    From Levothyroxine therapy in elderly patients with hypothyroidism (2021) · cites this paper as [12]

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  1. [33]Glenn GC Practice parameter on laboratory panel testing for screening and case finding in asymptomatic adults. Laboratory Testing Task Force of the College of the American Pathologists Arch Pathol Lab Med 1996 120 10 929 943 12049072
  2. [34]American Academy of Family Physicians Summary of Policy Recommendations for Periodic Health Examinations Leawood, KS American Academy of Family Physicians 2002 11996428

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Authors
Bensenor, I., Lotufo, P., & Diaz-Olmos
Affiliations
Universidade de São Paulo (BR)
ORCID
Lotufo, Paulo
Venue
Clinical Interventions in Aging
Publisher
Informa UK Limited
Published
2012-04
Volume
7
Pages
97
ISSN
  • 1176-9092 (ISSN-L)
  • 1178-1998
DOI
10.2147/cia.s23966
PMC
PMC3340110
OpenAlex
W1963556467
Cited by
139
References
92
Citations by year
2026: 4 · 2025: 13 · 2024: 7 · 2023: 14 · 2022: 11 · 2021: 11 · 2020: 14 · 2019: 19 · 2018: 13 · 2017: 8 · 2016: 8 · 2015: 7 · 2014: 4 · 2013: 3 · 2012: 3
FWCI
0.75
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Interventions in Aging (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
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, older adults, overt hypothyroidism, subclinical hypothyroidism, thyroid-stimulating hormone, free thyroxine, L-thyroxine therapy, myxedema, thyroid function monitoring, cardiovascular mortality, lipid profile
MeSH terms
Aged, Aged, 80 and over, Humans, Hypothyroidism, Thyrotropin, Thyroxine

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