Even the interpretations of the thyroid tests may be skewed in the elderly due to other medical conditions or medications. In addition, the normal ranges may need to be adjusted slightly for this age group. Thyroid production normally decreases with age.
Hypothyroidism in the elderly may or may not be treated depending on the person's medical condition and the severity of the disease. Practitioners are particularly cautious when heart disease is also present. Excess thyroid replacement also may increase the rate of bone loss in osteoporosis .
When hypothyroidism is treated, thyroid replacement is usually begun at a much lower dose and increased slowly to a dose that results in normal blood levels to avoid the symptoms of over replacement. Nervousness, sweating, heat intolerance, weight loss, palpitations and chest pain may all be caused by too much replacement hormone.
Graves' Disease or thyroid nodules usually cause hyperthyroidism in the elderly as in the rest of the population. It is generally treated with anti-thyroid drugs initially. Once the blood levels are normalized, some form of permanent treatment like radioactive iodide may be considered.
Treatment of thyroid disease in the elderly may be difficult due to co-existing medical conditions and the lack of demonstrable symptoms. However, the occurrence rates are common enough to warrant screening when signs and symptoms do occur and in the presence of confusion and/or dementia. Sadly, in days past people were institutionalized for dementia due to thyroid disease, which could have been easily treated.
For more information: Thyroid Disease in Late Life
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