Vail Daily column: Thyroid issues in the elderly often difficult to diagnosis
May 29, 2017
Aging is a normal process the body goes through, but not all of the symptoms that are frequently attributed to the normal aging process should be directly connected to aging — some may be associated with other illnesses such as hyperthyroidism or hypothyroidism.
Hyperthyroidism, or too much thyroid hormone, in the elderly is often difficult to diagnosis. While multiple symptoms may be present in a younger population, the elderly may only present with one or two symptoms. According to the Cleveland Clinic, in the elderly population, "typical symptoms (such as weight loss, fatigue, tremors, palpitations, atrial fibrillation, anxiety, depression, shortness of breath, heat intolerance, eye symptoms and anemia) may be absent or attributed to aging or another chronic illness." As such, subtle signs should be looked for.
Symptoms and signs of hypothyroidism may include weight gain, sleepiness, dry skin and constipation; however, a lack of these symptoms does not negate a diagnosis. To make a diagnosis in the elderly patient, doctors often need a high index of suspicion.
When attempting to diagnosis hypothyroidism in the elderly, doctors often look at a person's family history of thyroid disease, past treatment for hyperthyroidism or a history of extensive surgery and/or radiotherapy to the neck.
Due to the high incidence and prevalence of irregular heart rhythms, congestive heart failure, weight loss, nervousness and muscle weakness in our elderly, it is wise to carefully review with a physician the possibility of such illness being related to hypothyroidism.
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Knowledge is the key. Tests, such as T4 and T3U (or T3 Uptake), can be performed to help evaluate the presence of either hyper or hypothyroidism. Replacement hormone therapy (L-T4) is effective in hypothyroidism, whereas in hyperthyroidism (the over production of thyroid hormone) an antithyroid medication is often prescribed to reduce production of the thyroid hormone with sedatives and beta-blockers utilized to treat the associated rapid heart rate and nervousness.
talk to your doctor
The issue here is that many seniors are never diagnosed properly as having hyper or hypothyroidism but, rather, are told their symptoms are typical of anyone in their stage of the aging process. It requires both the family and the physician of the elder to carefully review the mishmash of symptoms that plague us as we age, sort out what is "normal" in the aging process and what might be associated with some other diagnosis (such as hypothyroidism).
Simple tests can determine if the suspicions are valid. Treatment is relatively benign and, in the case of hyperthyroidism, can often be normalized in three to six months with subsequent medication therapy less aggressive in nature.
Bottom line: Don't simply assume that when a physician proclaims that you have an issue (i.e., high cholesterol) that you should begin to receive medication therapy to help reduce those cholesterol levels (given that diet and exercise did not lower the levels significantly); ask why the cholesterol is high to begin with — you may find it's high due to hypothyroidism. Remember, knowledge is power.
Judson Haims is the owner of Visiting Angels Home Care in Eagle County. Contact him at 970-328-5526 or visit http://www.visitingangels.com/comtns.