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CC BY-NC-ND 4.0 · Journal of Diabetes and Endocrine Practice 2024; 07(03): 118-128
DOI: 10.1055/s-0044-1788596
Review Article

Hypothyroidism in Older Adults: A Concise Review of the Recent Literature

Kamal Abouglila
1   Department of Endocrinology, County Durham and Darlington NHS Foundation Trust, Durham, United Kingdom
,
Syed Fahim Mukhtar
2   Department of Geriatric Medicine, University Hospital Lewisham, London, England, United Kingdom
,
Issam M. Hajjaji
3   Department of Medicine, Faculty of Medicine, University of Tripoli, Tripoli, Libya
,
Shehla Sheikh
4   KGN Diabetes & Endocrinology Centre, Mumbai, Maharashtra, India
,
Salem A. Beshyah 
5   Department of Medicine, Dubai Medical College, Dubai, United Arab Emirates
6   Department of Endocrinology, Yas Clinic Khalifa City, Abu Dhabi, United Arab Emirates
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Abstract

Introduction Hypothyroidism (HypoT) is a common condition whose prevalence varies according to regional and ethnic factors, dietary iodine, gender, and age. The symptoms of HypoT are generally nonspecific, with considerable overlap with other conditions. These symptoms are not useful for diagnosing HypoT, and a thyroid function test is required for a final diagnosis.

Materials and methods We aimed to provide an overview of the recent global literature on HypoT in older adults. A narrative, nonsystematic review of the international literature from a single major medical online database (PubMed) for the past 5 years was performed. The relevant literature was narrated in a concise thematic account.

Results Most studies and expert opinions reiterated the benefit of replacement therapy in younger and middle-aged individuals. A good volume of literature also considered the interplay between thyroid hormones and (1) cardiovascular function and risk factors, (2) cognitive function, (3) mental health, and (4) quality of life. Most workers are cognizant of the important difference in normal ranges of thyroid-stimulating hormone (TSH) and the consequent TSH targets in older adults compared to younger age groups. Extra care is recommended for the initiation and titration of thyroid hormone replacement therapy to avoid cardiovascular and skeletal adverse effects of relative overtreatment.

Conclusion While clinical benefit is evident in patients under age 65 with overt and subclinical HypoT who are treated with levothyroxine, treatment may be harmful in older adults with subclinical HypoT. The 97th percentile of TSH distribution is 7.5 mIU/L for patients over age 80. Hence, TSH goals should be individualized in older adults to achieve any possible benefit and avoid unnecessary harm.

Keywords

hypothyroidism - subclinical hypothyroidism - thyroid hormones - older adults - cardiovascular quality of life - cognitive function

Authors' Contributions

All authors reviewed the whole document for intellectual content. All authors approved its final version.


Disclaimer

To the best of our abilities, we presented our perception of the published work in good faith. Original authors cannot be held responsible for any misrepresentation.




Publication History

Article published online:
05 August 2024

© 2024. Gulf Association of Endocrinology and Diabetes (GAED). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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