which symptom of thyroid disease is seen in older adults

Full Answer

What are the symptoms of an over-active thyroid in older people?

However, while younger people with thyroid disorders often experience multiple symptoms related to the over-active thyroid (weight loss, palpitations, sweating, nervousness, tremors) older people may only have a few symptoms, for example some heart palpitations and chest discomfort on climbing stairs.

How does hypothyroidism affect the elderly?

Psychiatric problems. Clinical depression—a common symptom in younger people with hypothyroidism—can also affect older people with the condition. The difference is that in older people it can be the only hypothyroidism symptom. Some older adults also develop psychosis with delusional behavior or hallucinations.

Can a 60 year old have hypothyroidism symptoms?

Hypothyroidism symptoms and signs in an older person November 24, 2020 Some people over age 60 have few, if any, symptoms of an underactive thyroid gland (hypothyroidism), while others experience the same symptoms younger people do. Still others have hypothyroidism symptoms that are not typical at all, making the diagnosis even more difficult.

How is the presence of thyroid disease determined in the elderly?

An important clue to the presence of thyroid disease in an elderly patient is a history of thyroid disease in another close family member such as a brother, sister or child of the patient.

See more

What symptoms of thyroid disorders could be difficult to identify in older adults Why?

The presence of nodules and atrophy of thyroid gland with advancing age makes the clinical diagnosis difficult. The classical signs and symptoms of hyperthyroidism in the younger age group, like tremor, weight loss, palpitation, diarrhea and heat intolerance, may be absent in the elderly.

What are the symptoms of thyroid problems in older females?

SymptomsFatigue.Increased sensitivity to cold.Constipation.Dry skin.Weight gain.Puffy face.Hoarseness.Muscle weakness.More items...•

What might be a presenting symptom of hyperthyroidism in the elderly?

Instead, cardiovascular symptoms and signs often predominate in older patients, including atrial fibrillation. Other findings more common in older patients with hyperthyroidism include fatigue, anorexia, weight loss, apathy, agitation, or cognitive decline (11-14).

What is the most common type of thyroid condition in the elderly?

Hypothyroidism in the older patient Hypothyroidism is the most common thyroid condition in patients over 60 years of age and steadily increases with age.

What happens to thyroid as you age?

The endocrine organs, including the thyroid gland, undergo important functional changes during aging. It is known that the prevalence of thyroid disorders increases with age. Importantly, subclinical disturbances of thyroid function are more frequent than overt diseases in the elderly.

Is hypothyroidism common in elderly?

Hypothyroidism is very common in patients over 60 years of age and steadily increases with age (see Hypothyroidism brochure). Up to 1 in 4 patients in nursing homes may have undiagnosed hypothyroidism.

Are symptoms of hyperthyroidism the same for adults as they are for older adults?

Two-thirds of older adults with hyperthyroidism will present similarly to younger patients. Symptoms will be consistent with sympathetic overactivity and include tremors, anxiety, palpitations, weight loss and heat intolerance. However, one-third of older adults will present with apathetic hyperthyroidism.

What is normal TSH level in elderly?

The American Thyroid Association (ATA) suggests raising the target serum TSH to 4-6 mIU/L in people age 70 to 80 years.

Does T4 decrease with age?

In this study, the median TSH increased and T4 decreased after age 20 in all ethnic groups, even after excluding thyroid antibody status and other risk factors.

What are the classic symptoms of hypothyroidism?

Common symptoms include:tiredness.being sensitive to cold.weight gain.constipation.depression.slow movements and thoughts.muscle aches and weakness.muscle cramps.More items...

Does TSH increase with age?

TSH levels do increase with age and using age-specific reference TSH ranges does slightly reduce the fraction of elderly patients who would be otherwise be diagnosed with subclinical hypothyroidism and perhaps unnecessarily treated with thyroid hormone replacement.

Do thyroid hormones decrease with age?

Namely, with increasing age in males there were decreases in free thyroid hormones but not in TSH concentrations. In turn, in females, the free thyroid hormone levels were not changed with aging but TSH level increased in age-dependent manner [28].

How does your body feel when you have thyroid problems?

Symptom: Changes in Energy or Mood Thyroid disorders can have a noticeable impact on your energy level and mood. Hypothyroidism tends to make people feel tired, sluggish, and depressed. Hyperthyroidism can cause anxiety, problems sleeping, restlessness, and irritability.

What is a normal thyroid level for a 70 year old woman?

Low TSH levels usually mean that you're producing too much thyroid hormone.Age rangeNormalHigh18–30 years0.5–4.1 mU/L> 4.1 mU/L31–50 years0.5–4.1 mU/L> 4.1 mU/L51–70 years0.5–4.5 mU/L> 4.5 mU/L71–90 years0.4–5.2 mU/L> 5.2 mU/L

How do I check my thyroid at home?

0:101:00How to Do a Self Thyroid Exam - YouTubeYouTubeStart of suggested clipEnd of suggested clipMen. You want to look between the collar bone and the Adam's apple you want to look for any lumps orMoreMen. You want to look between the collar bone and the Adam's apple you want to look for any lumps or bumps when you swallow women the Adam's apple is and that's visible.

How do I know if I have a thyroid issue?

One of the most definitive ways to diagnose a thyroid problem is through blood tests. Thyroid blood tests are used to tell if your thyroid gland is functioning properly by measuring the amount of thyroid hormones in your blood. These tests are done by taking blood from a vein in your arm.

Definition: What Do The Following Patients Over The Age of 60 Years Have in Common?

1. A 72 year old woman with “fluttering of the heart” and vague chest discomfort on climbing stairs 2. An 80 year old man with severe constipation...

Hyperthyroidism in The Older Patient

As in all hyperthyroid patients, if there is too much thyroid hormone, every function of the body tends to speed up (see Hyperthyroidism brochure)....

Treatment of The Older Patient With Hyperthyroidism

As with younger patients, treatment of hyperthyroidism in the older patient includes antithyroid drugs and radioactive iodine (see Hyperthyroidism...

Hypothyroidism in The Older Patient

Hypothyroidism is very common in patients over 60 years of age and steadily increases with age (see Hypothyroidism brochure). Up to 1 in 4 patients...

Treatment of The Older Patient With Hypothyroidism

As with the younger patient, pure synthetic thyroxine (L-T4), taken once daily by mouth, fully replaces the function of the thyroid gland and succe...

What are the signs of hypothyroidism in older people?

Any of the following signs and symptoms can indicate hypothyroidism in an older person. Unexplained high cholesterol. High cholesterol is sometimes the only evidence of an underactive thyroid in an older person. Because this sign may stand alone, high cholesterol warrants a thyroid evaluation. Heart failure.

When does hypothyroidism start in 2020?

Hypothyroidism symptoms and signs in an older person. November 24, 2020. Some people over age 60 have few, if any, symptoms of an underactive thyroid gland (hypothyroidism), while others experience the same symptoms younger people do.

What is the pain in the legs from hypothyroidism?

Joint or muscle pain. Vague joint pain is a classic hypothyroidism symptom. It sometimes is the only symptom of hypothyroidism in an older person. Many people experience general muscle aches, particularly in large muscle groups like those in the legs.

Why does my heart feel so slow?

Heart failure. Reduced blood volume, weaker contractions of the heart muscle, and a slower heart rate— all caused by low thyroid hormone levels—can contribute to heart failure, when your heart can't pump out blood as effectively as it should The ineffective pumping may cause subtle symptoms such as feeling less energetic or just walking more slowly. In more advanced stages, fluid can back up in the lungs and legs causing shortness of breath and leg swelling.

Can depression affect older people?

Psychiatric problems. Clinical depression—a common symptom in younger people with hypothyroidism—can also affect older people with the condition. The difference is that in older people it can be the only hypothyroidism symptom. Some older adults also develop psychosis with delusional behavior or hallucinations.

What are the symptoms of hyperthyroidism?

The following symptoms are most common among older adults with hyperthyroidism: Abnormal heart rhythms (such as atrial fibrillation or a rapid heartbeat) Heart failure. Muscle weakness and loss of muscle.

How do you know if you have a thyroid nodule?

Many thyroid nodules cause no obvious symptoms and most people don’t realize they have a nodule until their healthcare provider detects it during a routine check-up. Approximately 90% of women over 70 years old and 60% of men over 80 years old have thyroid nodules. Most of these nodules are not palpable (which means your healthcare provider cannot feel them). These nodules are often detected incidentally on imaging studies done for other reasons. Sometimes, though, a nodule can get big enough to be noticeable. Thyroid nodules may eventually get large enough for you to see, or they may press on your throat, making it is uncomfortable or difficult to breathe or swallow.

What hormones are produced by thyroid nodules?

Some nodules increase the amount of triiodothyronine hormone (T3) that your thyroid produces, causing symptoms of hyperthyroidism. A small percentage of thyroid nodules become cancerous. Last Updated July 2020.

What is Graves' ophthalmopathy?

Graves’ ophthalmopathy, a symptom of Grave’s disease in which the eyes begin to bulge outward. Graves’ ophthalmopathy is more common among older than younger adults with hyperthyroidism. Erectile dysfunction. Thyroid disorders can also cause psychiatric symptoms, including mania, panic attacks, and anxiety.

What happens if you don't treat hypothyroidism?

You should contact your healthcare provider as soon as possible if you notice these common symptoms of the disease: Low energy levels and slowed thinking. Depression. Weight gain. Muscle weakness, aches, tenderness, or stiffness. Constipation.

Can hypothyroidism cause heart failure?

Untreated hypothyroidism can also increase your risk of heart disease, an enlarged heart, and heart failure. Over time, it can damage your nerves and cause loss of muscle control as well. Advanced untreated hypothyroidism can lead to a fatal complication known as “myxedema coma.”.

Can thyroid problems cause anxiety?

Thyroid disorders can also cause psychiatric symptoms, including mania, panic attacks, and anxiety.

What do older adults need to know about thyroid?

5 Things Older Adults Need to Know About Thyroid Disorders. These conditions aren’t always easy to detect, especially after age 60. Here’s how to protect yourself. Your thyroid, a butterfly-shaped gland in your neck, is small but powerful. When everything is working properly, it secretes hormones that control your metabolism and, in turn, ...

What to do if you have an overactive thyroid?

If you suspect you might have an underactive or overactive thyroid, consider making an appointment with an endocrinologist and ideally one who has experience working with older adults. Check with your health plan to find an endocrinologist, or search for one through AACE.

How many people have hypothyroidism at 12?

About five out of 100 people age 12 and up have hypothyroidism, but as you age, the risk increases. By the time you’re in your 60s, the chances of having it are about 6 to 10 percent, says Aaron Vinik, M.D., Ph.D., a board member of the American Association of Clinical Endocrinologists (AACE).

Is a blood test for hypothyroidism accurate?

Your Blood Tests Might Be Inaccurate. Both hypothyroidism and hyperthyroidism are usually diagnosed with blood tests that check your levels of different hormones. But these tests aren’t always accurate in older adults, Dr. Vinik says.

Can you get constipated with hypothyroidism?

When younger people develop thyroid problems, the symptoms tend to be straightforward. Although older adults with hypothyroidism may also become constipated, feel cold and sluggish, and have dry skin, those symptoms “are all features you’d typically find in older people in general,” Dr. Vinik says.

Is it easy to detect thyroid disease?

The catch: Thyroid conditions aren’t always easy to detect, especially after age 60. Here’s what you should know about these disorders and how to protect yourself. 1. They’re More Common Than You Think. About five out of 100 people age 12 and up have hypothyroidism, but as you age, the risk increases. By the time you’re in your 60s, the chances of ...

Is T4 normal for thyroid?

What’s more, some people have so-called subclinical thyroid disorders, meaning that their thyroid-stimulating hormone (TSH) levels are high but their level of another hormone, called free T4, is normal. But these patients may still need to be treated.

How common are thyroid disorders in older people and how do symptoms differ in the elderly?

Several studies referring to those over 65 years show that thyroid illness is very much a disease of the elderly and that it often goes undiagnosed. Although the incidence of thyroid problems increases with age, it is sometimes difficult to diagnose as symptoms are not always as widespread or obvious as those in younger patients.

What is the most common thyroid condition in older people?

Hypothyroidism in the older patient. Hypothyroidism is the most common thyroid condition in patients over 60 years of age and steadily increases with age. A screening study that evaluated more than 25,000 individuals attending a health fair in Colorado revealed that 10% of men and 16% of women age 65-74 had TSH levels that were increased above ...

What is the treatment for hyperthyroidism in older people?

As with younger people, treatment of hyperthyroidism in older people includes antithyroid drugs and radioactive iodine. Surgery is rarely recommended due to increased risks associated with operations in older people. While Graves’ disease is still a common cause of hyperthyroidism in this age group, toxic nodular goitre (either in the form of multiple nodules or a single over-active nodule), resulting in hyperthyroidism, is more frequent than in younger individuals. The latter is not associated with the eye problems that are sometimes seen in Graves' disease).

Is it difficult to diagnose thyroid problems?

Although the incidence of thyroid problems increases with age, it is sometimes difficult to diagnose as symptoms are not always as widespread or obvious as those in younger patients. While some of the symptoms of hyperthyroidism and hypothyroidism in older patients are similar to those in younger patients, symptoms of both disorders often manifest ...

Can thyroid disease be treated with antithyroid drugs?

During treatment for an over-active thyroid, the effects of change in thyroid function on other body systems are closely monitored, due to an increased likelihood of co-existing diseases – cardiac, central nervous system and thyroid – in older patients. Most often , thyroid function is brought under control first with antithyroid drugs ...

Can radioactive iodine be used for hyperthyroidism?

During the initial phase of treatment, doctors will check heart function closely due to the effect of changing thyroid hormone levels on the heart. Symptoms of hyperthyroidism may be brought under control with other medications alongside the antithyroid drugs such as beta-blockers, which are often given to slow a rapid heart rate. Definitive treatment with radioactive iodine is considered once thyroid function is maintained in the normal range with oral medication.

Does levothyroxine help with hypothyroidism?

A further study led by Professor David Stott of Glasgow University of hundreds of older adults across Europe with mild hypothyroidism has shown that this group does not benefit from being treated with levothyroxine in respect of improving symptoms or quality of life.

Why is thyroid disease so difficult to diagnose?

Sometimes, thyroid disease can be difficult to diagnose because the symptoms are easily confused with those of other conditions. You may experience similar symptoms when you are pregnant or aging and you would when developing a thyroid disease. Fortunately, there are tests that can help determine if your symptoms are being caused by a thyroid issue. These tests include:

What are the two main types of thyroid disease?

The two main types of thyroid disease are hypothyroidism and hyperthyroidism. Both conditions can be caused by other diseases that impact the way the thyroid gland works. Conditions that can cause hypothyroidism include: Thyroiditis: This condition is an inflammation (swelling) of the thyroid gland.

What is it called when your thyroid makes too much or too little?

When your thyroid makes either too much or too little of these important hormones, it’s called a thyroid disease. There are several different types of thyroid disease, including hyperthyroidism, hypothyroidism, thyroiditis and Hashimoto’s thyroiditis.

How long does it take for thyroid to heal after surgery?

The hormones can still be in your body for two to three weeks. Medication will reintroduce new hormones into your body after the thyroid has been removed. If you are still feeling tired after surgery, remember that this can be a normal part of recovering from any type of surgery. It takes time for your body to heal. Talk to your healthcare provider if you are still experiencing fatigue and other symptoms of thyroid disease after surgery.

How many people have thyroid disease?

Thyroid disease is very common, with an estimated 20 million people in the Unites States having some type of thyroid disorder. A woman is about five to eight times more likely to be diagnosed with a thyroid condition than a man.

Is diabetes a thyroid disease?

If you have diabetes, you’re at a higher risk of developing a thyroid disease than people without diabetes. Type 1 diabetes is an autoimmune disorder. If you already have one autoimmune disorder, you are more likely to develop another one.

Do you have to change your exercise routine if you have thyroid disease?

Regular exercise is an important part of a healthy lifestyle. You do not need to change your exercise routine if you have a thyroid disease. Exercise does not drain your body’s thyroid hormones and it shouldn’t hurt you to exercise. It is important to talk to your healthcare provider before you start a new exercise routine to make sure that it’s a good fit for you.

What are the physical symptoms of hypothyroidism in elderly people?

Physical findings evident in hypothyroid elderly individuals may include bradycardia, diastolic hypertension, pallor, dry skin, coarse hair, hoarseness, dysarthria, delayed relaxation of deep tendon reflexes, and mental status changes (31). The severity of specific findings may be exacerbated by comorbid cardiovascular, neuropsychiatric, dermatologic, or rheumatologic conditions that are more common among the elderly (32). In some cases it may be necessary to evaluate responses to thyroid hormone replacement to determine the extent to which certain findings represent manifestations of thyroid hormone deficiency.

Why is hypothyroidism more common in elderly people?

Hypothyroidism is more common among elderly individuals due to the increasing incidence and prevalence of autoimmune thyroiditis that occurs with aging.

What is mild hypothyroidism?

Mild or subclinical hypothyroidism, which is characterized by an increased TSH level with concomitant free thyroid hormone levels that fall within normal limits , is very common among elderly men and women. The estimated prevalence of this condition has varied from 4-15%. A study evaluating a community of healthy elderly adults in the southwest of France reported that 4.2% of subjects presenting with increased TSH levels had normal free T4 levels (111). Within this group, mild hypothyroidism was linked with an increased prevalence of symptoms of depression. A study that evaluated thyroid function profiles in a bi-ethnic urban community reported that mild hypothyroidism was more commonly identified in females and non-Hispanic white subjects than Hispanic subjects (112). Stratified analysis of the impact of mild hypothyroidism in this population revealed no significant alterations in health status measures in subjects with TSH levels ranging between 4.7-10.0 mIU/L. A study that inventoried clinical findings of hypothyroidism in a population of geriatric clinic patients reported that while 15.4% of the men and 14.6% of the women screened met criteria for mild hypothyroidism, the incidence of symptoms and signs consistent with thyroid hormone deficiency detected in these subjects was similar to that reported for euthyroid subjects (113). An array of studies that have tracked changes in thyroid function in cohorts of aging subjects in the United States, Australia, the Netherlands, Spain, the United Kingdom, and China have reported that the development of hypothyroidism in elderly patients does not appear to be associated with any change in cognitive function, increased levels of depression, or diminished ability to perform activities of daily living (114–120). A study that measured an array of anthropometric, biochemical, and neuropsychiatric parameters in Korean subjects aged 65 years and older showed that subclinical hypothyroidism did not appear to be associated with any discernible metabolic or neuropsychiatric derangements (121). A study that evaluated subgroups of subjects enrolled in the Health, Aging, and Body Composition study found that those determined to have mild subclinical hypothyroidism (defined by a TSH level of 4.5-7.0 mIU/L with normal thyroid hormone levels) demonstrated better mobility, cardiorespiratory fitness, and walking ease than subjects who were euthyroid or determined to have moderate subclinical hypothyroidism (defined by a TSH level of 7.0-20.0 with normal thyroid hormone levels) (122). An analysis of subgroups in this cohort study identified increased odds of prevalent metabolic syndrome among subjects with TSH levels > 10 (123). A study that evaluated postmenopausal women at risk for development of osteoporosis reported that subclinical hypothyroidism was not associated with decreased bone mineral density or an increased risk of vertebral or non-vertebral fracture (124).

What is the TSH level of a person over 80?

Future estimates of the prevalence of hypothyroidism among the elderly based on current definitions may need to factor in growing evidence that normal TSH distribution curves appear to be shifted towards higher value ranges in older individuals. Age-specific analysis of TSH levels and anti-thyroid antibody titers measured as part of the most recent NHANES study demonstrated that 12% of subjects aged 80 and older without any evidence of underlying autoimmune thyroiditis had TSH levels greater than 4.5 mIU/L (13). In this analysis, the upper 95% confidence limit for TSH in euthyroid individuals over age 80 was 7.5 mIU/L (13).

How accurate is a TSH test for primary hypothyroidism?

Accurate diagnosis of primary hypothyroidism in the elderly relies primarily, as it does in all patients, on the measurement of a sensitive serum TSH level. Although data from the NHANES III study has established that median TSH levels appear to increase with advancing age, the normal upper limit of an established reference range may still be used as a cutoff to confirm the diagnosis of primary hypothyroidism in most elderly patients. While a blood spot TSH level has been shown to be an adequate screening test for the detection of overt primary hypothyroidism in the elderly, it may not be sensitive enough to detect cases of subclinical hypothyroidism characterized by elevated serum TSH levels with normal T4 or free T4 levels (53). One study has determined that there may be a negative correlation between age and the degree to which TSH levels are elevated in elderly patients presenting with primary hypothyroidism (54).

Why do elderly people need thyroxine?

Thyroxine dose requirements in elderly patients may be related to several factors including declining metabolic clearance, progression of underlying thyroid failure, declining body mass, and interactions with other medications prescribed for the treatment of co-morbid conditions (88,89). On average, elderly patients with primary hypothyroidism receive initial daily doses that are 20 mcg lower and maintenance daily doses that are 40 mcg lower than those prescribed for younger and middle-aged patients (90–92). One study suggested that lean body mass may be a better predictor of daily replacement doses than age or weight alone (93). Another reported that most of the age-dependent differences in thyroxine requirements noted might be attributed to the effects of chronic disease, since substantially lower average daily replacement doses were reported by elderly patients treated for other chronic medical disorders (94). A study that tracked changes in elderly patients’ thyroxine requirements over time based on the etiology of their primary hypothyroidism reported that daily replacement doses increased in patients who initially presented with autoimmune thyroiditis or postsurgical hypothyroidism, decreased in patients who initially presented with post-ablative hypothyroidism, and did not change in patients who initially presented with subclinical hypothyroidism or drug-induced hypothyroidism (95).

What is the most common cause of hypothyroidism in the elderly?

Autoimmune thyroiditis is the most common cause of hypothyroidism among the elderly, as it is in younger persons (16–18). A survey of endocrinology clinic patients revealed that 57% of patients aged 55 and older presenting with primary hypothyroidism carried a diagnosis of autoimmune thyroiditis, while 32% carried a diagnosis ...