Thyroid-Function Tests in the Elderly

Jefferys, Peter; Hoffenberg, R.; Farran, Helen E. A.; Fraser, Patricia; Hodkinson, H. M.

doi:10.1016/s0140-6736(72)91494-8

Cited by 34 publications

(13 citation statements)

References 10 publications

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“…N umerous studies have reported a decrease of triiodothyronine (T3) and a rise in reverse T3 (rT3) in elderly subjects, suggesting that old age alters thyroid hormone metabolism in peripheral tissues resulting in altered thyroid hormone concentrations 1–7 . However, other authors have questioned the so‐called healthy status of the subjects in these previous studies, since they observed no changes in thyroid hormone concentrations in elderly healthy subjects in their studies 8–11 . Furthermore, we recently reported that in elderly subjects with type II diabetes mellitus, the decline in serum T3 and rise in rT3 occurred only if the metabolic control was poor, and old age per se appeared to have no effect on thyroid hormone levels 12 .…”

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confidence: 97%

Thyroid Hormone Indices in Adult Healthy Subjects: No Influence of Aging

Kabadi

Rosman

1988

J American Geriatrics Society

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Controversy exists regarding the influence of aging on thyroid hormone metabolism. Several investigators report lowering of T3 and/or a rise in reverse T3 (rT3) in elderly subjects. Others suggest that these thyroid hormone alterations were secondary to associated disorders rather than old age, and questioned the "healthy" status of the subjects studied in the earlier reports. Therefore, to assess the possible effect of aging we studied T3 resin uptake, T4, free T4, T3, and rT3 concentrations in 152 euthyroid healthy adult subjects. These subjects were selected carefully and were therefore devoid of any illness, acute or chronic, and were not treated with any medications at the time of study. No significant alterations were noted in any of the thyroid hormone concentrations in subjects divided into groups according to age. Nor was there a significant difference in these parameters between men and women of any individual age group or for all ages combined. Therefore, old age per se may not influence thyroid hormone metabolism and hence may not induce changes in serum thyroid hormone concentrations. The changes in thyroid hormones noted previously in elderly subjects may be a reflection of concurrent disorders and not old age.

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confidence: 97%

Thyroid Hormone Indices in Adult Healthy Subjects: No Influence of Aging

Kabadi

Rosman

1988

J American Geriatrics Society

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“…Although more pro¬ nounced among women, this increasing prominence of those over 59 years old was seen in both sexes as well as in users of both major classes of thyroid agents (synthetic moreso than natural). Although the higher prevalence of thyroid hormone usage among the elderly has been reported by others (12) and several studies have found hypothyroidism to be more common in elderly than in younger populations (31)(32)(33)(34)(35)(36)(37) (particularly among women, 35,36), an increase over time in per capita usage of thyroid hormone among the elderly has not been reported previously.…”

Section: Discussionmentioning

confidence: 78%

Thyroid Hormone Use: Trends in the United States from 1960 Through 1988

Kaufman

Gross²,

Kennedy³

1991

Thyroid

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Thyroid hormone preparations comprised over 1% of all prescriptions filled by retail pharmacies during 1988 in the conterminous United States, i.e., the 48 contiguous states. Their large market share gives the patterns of their use substantial public health importance. This article describes prescription thyroid hormone use in the United States from 1960 through 1988, using pharmaceutical marketing research data collected from panels of retail pharmacies and office-based physicians. Although the use of natural products has declined by over 50% since 1960, about one fourth of all thyroid hormone prescriptions were for natural preparations as recently as 1988. Per capita thyroid mentions (i.e., patient-physician contacts during which a thyroid agent of any kind was recommended, prescribed, dispensed, administered, ordered to be given by a hospital, or given as a sample) doubled during this period among those over 59 years old. Per capita mentions for synthetic thyroid products increased fourfold and tenfold among men and women in this age group, respectively. Use for weight loss, despite the label's boxed warning indicating it to be ineffective and potentially dangerous, has diminished but persists. Obesity was second only to hypothyroidism among the diagnoses underlying thyroid product mentions.

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“…Jefferys et al (6), in a study of 490 euthyroid patients admitted to a geriatric department, found that the PBI level was low in 20 percent. Abnormalities of the PBI and T 3 U were positively correlated with decreased serum albumin.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years the methods for measuring circulating thyroid hormones have improved (4, 5) and new information is available on thyroid function tests, especially in elderly patients (6–10). Therefore it seemed pertinent to report a comparison of the results of thyroid function tests in 35 hyperthyroid patients above the age of 65 with the results in 48 hyperthyroid patients below that age.…”

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confidence: 99%

Thyroid Function Tests in Elderly Hyperthyroid Patients

Caplan

Glasser

Davis

et al. 1978

J American Geriatrics Society

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Several tests of thyroid function were performed in 35 hyperthyroid patients over the age of 65 (elderly). The results were compared to those of similar tests in 48 hyperthyroid patients under the age of 65 (young). Total serum thyroxine (T4) was within the normal range in 14 percent of the elderly and 11 percent of the young hyperthyroid patients. The free thyroxine index (FTI) was within the normal range in 11 percent of both groups. The triiodothyronine uptake (T3U) proved to be a poor test in both groups. Although elevation of the triiodothyronine (T3) level allowed a diagnosis of "T3-toxicosis" in 2 elderly and 3 young hyperthyroid patients, the T3 level was normal in 34 percent of the elderly and 13 percent of the young subjects. Correction of the T3 range for age reduced the number of normal T3 values to 12.5 percent in the elderly hyperthyroid patients. The 24-hour uptake of radioactive iodine was normal in 12 percent of the young hyperthyroid patients, 27 percent of the elderly patients with Graves' disease, and 70 percent of the elderly patients with toxic nodular goiter, despite recent readjustment of the normal range for the test. It is concluded that the diagnosis of hyperthyroidism in the elderly may be difficult and that no single test can be relied upon to exclude the diagnosis.

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Thyroid-Function Tests in the Elderly

Cited by 34 publications

References 10 publications

Thyroid Hormone Indices in Adult Healthy Subjects: No Influence of Aging

Thyroid Hormone Indices in Adult Healthy Subjects: No Influence of Aging

Thyroid Hormone Use: Trends in the United States from 1960 Through 1988

Thyroid Function Tests in Elderly Hyperthyroid Patients

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