Aging and the thyroid

Sawin, Clark T.; Herman, Talia; Molitch, Mark E.; London, M.; Kramer, Sybil M.

doi:10.1016/0002-9343(83)91192-0

Cited by 118 publications

(5 citation statements)

References 20 publications

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“…This is best performed with levothyroxine. This is similar to findings in subjects with primary hypothyroidism [30]. Ferreti et al [4] examined a variety of clinical and biochemical parameters as indices of thyroid hormone action in 37 patients with CH, with and without administration of levothyroxine therapy.…”

Section: Therapysupporting

confidence: 66%

Central Hypothyroidism

Gudmundsdottir¹,

Schlechte

2002

The Endocrinologist

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Identify the causes and pathogenetic mechanisms underlying acquired, congenital, and transient central hypothyroidism (CH). • Describe the clinical and endocrinological characteristics of CH. • Recall the most effective treatment of CH, the best marker of treatment response, and the perils of undertreatment and overtreatment. Most patients with hypothyroidism have thyroid failure or primary hypothyroidism. Central hypothyroidism (CH) is caused by impaired stimulation of a normal thyroid gland by hypothalamic or pituitary hormones. Most cases of CH are caused by pituitary tumors, but genetic defects causing abnormalities in the thyroid-stimulating hormone (TSH) ␤ subunit also lead to CH. The symptoms are similar to those of primary hypothyroidism, and most patients with CH will also have signs and symptoms of other anterior pituitary dysfunction. The diagnosis of CH can be missed if a TSH is the only screening test used for detection of thyroid disease, and we recommend measurement of both free thyroxine and TSH for screening purposes. The treatment is the same as in primary hypothyroidism except that TSH cannot be used to monitor therapy. It is important to assess the pituitary adrenal axis before starting levothyroxine to avoid precipitation of adrenal crisis in patients with adrenal insufficiency. ■

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Section: Therapysupporting

confidence: 66%

Central Hypothyroidism

Gudmundsdottir¹,

Schlechte

2002

The Endocrinologist

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“…Several studies have shown that the levothyroxine dose requirement is decreased in older individuals [8, 48, 49]. However, a recent study suggests that this decreased requirement may be mediated by the changes in weight that may accompany ageing [26].…”

Section: Factors Potentially Contributing To the Need For Levothyroximentioning

confidence: 99%

Levothyroxine Dose Adjustment to Optimise Therapy Throughout a Patient’s Lifetime

Duntas¹,

Jonklaas

2019

Adv Ther

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Levothyroxine is the standard therapy for patients with hypothyroidism, a condition that affects up to 5% of people worldwide. While levothyroxine therapy has substantially improved the lives of millions of hypothyroid patients since its introduction in 1949, the complexity of maintaining biochemical and clinical euthyroidism in patients undergoing treatment with levothyroxine cannot be underestimated. Initial dosing of levothyroxine can vary greatly and may be based on the amount of residual thyroid function retained by the patient, the body weight or lean body mass of the patient, and thyroid-stimulating hormone levels. As levothyroxine is usually administered over a patient’s lifetime, physiological changes throughout life will affect the dose of levothyroxine required to maintain euthyroidism. Furthermore, dose adjustments may need to be made in patients with concomitant medical conditions, in patients taking certain medications, as well as in elderly patients. Patients who have undergone any weight or hormonal changes may require dose adjustments, and the majority of pregnant women require increased doses of levothyroxine. Optimal treatment of hypothyroidism requires a partnership between patient and physician. The physician is tasked with vigilant appraisal of the patient’s status based on a thorough clinical and laboratory assessment and appropriate adjustment of their levothyroxine therapy. The patient in turn is tasked with medication adherence and reporting of symptomatology and any changes in their medical situation. The goal is consistent maintenance of euthyroidism, without the patient experiencing the adverse events and negative health consequences of under- or overtreatment.Funding Merck.Plain Language Summary Plain language summary available for this article.

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“…The levothyroxine dose requirement gradually decreases with age,82,83 thought to be due to age-related decreases in thyroxine degradation84 and in lean body mass 85. Furthermore, levothyroxine replacement may precipitate severe angina or myocardial infarction in an elderly person with asymptomatic ischemic heart disease.…”

Section: Levothyroxine Replacement In Special Circumstancesmentioning

confidence: 99%

Treatment for primary hypothyroidism: current approaches and future possibilities

Chakera

Pearce²,

Vaidya

2011

DDDT

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Primary hypothyroidism is the most common endocrine disease. Although the diagnosis and treatment of hypothyroidism is often considered simple, there are large numbers of people with this condition who are suboptimally treated. Even in those people with hypothyroidism who are biochemically euthyroid on levothyroxine replacement there is a significant proportion who report poorer quality of life. This review explores the historical and current treatment options for hypothyroidism, reasons for and potential solutions to suboptimal treatment, and future possibilities in the treatment of hypothyroidism.

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Aging and the thyroid

Cited by 118 publications

References 20 publications

Central Hypothyroidism

Central Hypothyroidism

Levothyroxine Dose Adjustment to Optimise Therapy Throughout a Patient’s Lifetime

Treatment for primary hypothyroidism: current approaches and future possibilities

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