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Subclinical hypothyroidism (hypothyroidism) is one of the most common endocrine diseases in clinical practice, and is mainly characterized by a markedly elevated serum thyrotropin level (usually ≥4.
Hypothyroidism is more common in the elderly, and its main hazards are the development of clinical hypothyroidism and increased blood lipids, leading to atherosclerosis and coronary heart disease
The results of the analysis showed that the incidence of cardiovascular, musculoskeletal, and cognitive-related adverse prognostic events was not significantly increased in elderly patients with serum thyrotropin levels of 4.
Screenshot source: The Lancet Diabetes & Endocrinology
The pathogenesis of hypothyroidism is complex and usually caused by structural abnormalities of the thyroid itself or other organs
It should be noted that there is currently no uniform standard for the treatment of hypothyroidism in different guidelines
Based on authoritative published data (including meta-analyses, randomized clinical trials, and cohort studies) over the past 10 years (January 1, 2010 to July 31, 2021), the researchers compared the elderly patients with hypothyroidism with different thyrotropin levels.
The results of the analysis showed that the symptoms of thyroxine deficiency in most elderly patients with hypothyroidism were usually not obvious, and after levothyroxine treatment, the symptoms of hypothyroidism and cardiovascular/skeletal indicators in elderly patients with hypothyroidism did not improve
Thyrotropin level: 4.
Thyrotropin level: 4.
Thyrotropin level: 7.
Thyrotropin level: 7.
Thyrotropin level: 10.
Thyrotropin level: 10.
▲ Treatment recommendations for elderly patients based on different thyrotropin levels (Image source: Reference [1])
The main goal of hypothyroidism treatment is to prevent the progression of hypothyroidism to clinical hypothyroidism, in addition to relieve symptoms related to hypothyroidism or prevent the occurrence of related adverse events
The researchers believe that levothyroxine therapy should be considered in elderly patients 65 years and older if thyrotropin levels are persistently higher than 7 mIU/L, and immediate treatment may not be considered if it is below 7 mIU/L
References
[1] Biondi, Bernadette, and Anne R.
