Antonio Maria Borzì1, Antonio Biondi1, Francesco Basile1, Marco Vacante2. 1. Department of General Surgery and Medical-Surgical Specialties, University of Catania, Via S. Sofia,78, 95123, Catania, Italy. 2. Department of General Surgery and Medical-Surgical Specialties, University of Catania, Via S. Sofia,78, 95123, Catania, Italy. marcovacante@yahoo.it.
Abstract
PURPOSE: To review the diagnosis and the treatment of both subclinical and overt hypothyroidism in old people, which could represent a challenge for the clinicians. METHODS: Narrative literature review. An extensive literature search was performed using the databases of Scopus, Medline through PubMed, and Google Scholar from January 1975 to May 2019. The search terms were "hypothyroidism," "older adults," "elderly," and "myxedema." RESULTS: Hypothyroidism is more common among older subjects in comparison to the younger counterparts. The hypothalamic-pituitary-thyroid axis and its hormones undergo significant changes due to the physiological aging process. For a correct diagnosis of hypothyroidism in old people clinicians must take such age-related changes into account. CONCLUSIONS: The administration of replacement therapy in older adults should consider frailty, polypharmacy and a high risk to develop overtreatment symptoms. On the other hand, older patients with untreated or undertreated hypothyroidism may develop a state of myxedema coma.
PURPOSE: To review the diagnosis and the treatment of both subclinical and overt hypothyroidism in old people, which could represent a challenge for the clinicians. METHODS: Narrative literature review. An extensive literature search was performed using the databases of Scopus, Medline through PubMed, and Google Scholar from January 1975 to May 2019. The search terms were "hypothyroidism," "older adults," "elderly," and "myxedema." RESULTS:Hypothyroidism is more common among older subjects in comparison to the younger counterparts. The hypothalamic-pituitary-thyroid axis and its hormones undergo significant changes due to the physiological aging process. For a correct diagnosis of hypothyroidism in old people clinicians must take such age-related changes into account. CONCLUSIONS: The administration of replacement therapy in older adults should consider frailty, polypharmacy and a high risk to develop overtreatment symptoms. On the other hand, older patients with untreated or undertreated hypothyroidism may develop a state of myxedema coma.
Authors: Wing May Kong; Maleyca H Sheikh; Peter J Lumb; Rossitza P Naoumova; Danielle B Freedman; Martin Crook; Caroline J Doré; Nicholas Finer; P Naoumova Journal: Am J Med Date: 2002-04-01 Impact factor: 4.965
Authors: M P Vanderpump; W M Tunbridge; J M French; D Appleton; D Bates; F Clark; J Grimley Evans; D M Hasan; H Rodgers; F Tunbridge Journal: Clin Endocrinol (Oxf) Date: 1995-07 Impact factor: 3.478
Authors: Jeffrey R Garber; Rhoda H Cobin; Hossein Gharib; James V Hennessey; Irwin Klein; Jeffrey I Mechanick; Rachel Pessah-Pollack; Peter A Singer; Kenneth A Woeber Journal: Endocr Pract Date: 2012 Nov-Dec Impact factor: 3.443
Authors: P S Hamblin; S A Dyer; V S Mohr; B A Le Grand; C F Lim; D V Tuxen; D J Topliss; J R Stockigt Journal: J Clin Endocrinol Metab Date: 1986-04 Impact factor: 5.958