Thyroid problems are common in older adults

Q. As an authentic geezer, I’ve had so many medical tests that I think I’ve seen more acronyms than were around during the New Deal. Recently, a friend of mine suggested that I get a TSH test for my thyroid. What, in the name of FDR, is a TSH test?

The thyroid is a small, butterfly-shaped gland located in the middle of the lower neck. It produces hormones that control metabolism, which are the chemical processes cells in the body perform to keep us alive.

It should come as no surprise that the thyroid gland often peters out as we get older. The thyroid stimulating hormone (TSH) test checks to see if your thyroid is producing the right amount of hormone for your system. If the gland is making too much hormone, you get hyperthyroidism; if it makes too little, you get hypothyroidism.

Hypothyroidism is very common in people over 60 years of age; the incidence of it steadily increases with age. About 25 percent of people in nursing homes may have undiagnosed hypothyroidism because the symptoms of this condition can be misinterpreted as signs of aging.

When thyroid disease is caught early, treatment can control the disorder even before the onset of symptoms.

Professional organizations differ widely on screening recommendations. Most do not recommend widespread screening for healthy adults.

The American College of Physicians recommends that women over 50 years old be screened for thyroid disorders every five years.

The American Academy of Family Physicians believes that adults do not have to be screened until they are over 60.

The American Thyroid Association, however, recommends that all adults, both men and women, begin their screening at age 35 and every five years thereafter. Experts in this organization argue that such early screening is inexpensive and would prevent progression to hypothyroidism, and therefore possibly heart disease, in people with subclinical hypothyroidism.

The U.S. Preventive Task Force recommends against routine screening for thyroid disease in adults.

The symptoms of hypothyroidism include: fatigue, intolerance to cold, constipation, forgetfulness, muscle cramps, hair loss, depression, weight gain, dry skin, hoarseness and mood swings.

The symptoms of hyperthyroidism include: weight loss (not always in seniors), heat intolerance, hyperactivity, muscle weakness, palpitations, tremors, nervousness, irritability, insomnia, enlarged thyroid gland, frequent bowel movements, vision problems or eye irritation.

About 27 million Americans of all ages have overactive or underactive thyroid glands, but more than half the conditions are undiagnosed. More than 80 percent of people with thyroid disease are women.

Thyroid diseases are lifelong, but treatable conditions. However, if untreated, thyroid disease can cause elevated cholesterol levels and subsequent heart disease, infertility, muscle weakness, osteoporosis and, in extreme cases, coma or death.

Treatment to balance your hormone levels is simple and not very expensive.

Hypothyroidism is treated with a drug called levothyroxine. This is a synthetic hormone tablet that replaces missing thyroid hormone in the body. With careful monitoring, your doctor will adjust your dosage, and you’ll soon be able to return to your normal lifestyle.

Hyperthyroidism, generally more difficult to treat, requires the normalization of thyroid hormone production. Treatment could involve drug therapy to block hormone production, radioactive iodine treatment that disables the thyroid, or even thyroid surgery.

The most popular treatment for hyperthyroidism is radioactive iodine. This therapy often causes hypothyroidism, requiring levothyroxine to bring the system back to normal.


If you would like to ask a question, write to fred@healthygeezer.com.