by Internet Medical Society

A study was published in Archives of Medicine with the objective of studying the spectrum of thyroid dysfunction in elderly and to correlate clinical symptoms with abnormal thyroid function. Methods: a total of 100 subjects aged more than 60 years, admitted to General Medicine IPD of MVJMC & RH who were suspected to be suffering from thyroid disorders or subjects with vague symptoms like generalized weakness, easy fatigability, lethargy, disinterest in daily activities, to be suspicious of thyroid disorder, were subjected to detailed clinical examination & thyroid function testing by biochemical means. Those who were found to have altered thyroid functions, thyroid antibody (TPO) test were done. When thyroid nodule was present, further relevant investigations like USG/FNAC neck was performed to make appropriate diagnosis. Results: a total of 100 patients were included in the study. Thyroid disorders were present in 25%. Overt hypothyroidism in 11%, subclinical hypothyroidism in 9% cases, hyperthyroidism in 2% and subclinical hyperthyroidism in 3% patients was noted. In this study 38 patients were males and 62 were females. Females (18%) had high incidence of thyroid disorders than males (7%). As the age advanced the incidence of thyroid dysfunction increased which was statistically significant. Overt hypothyroidism was more common among elderly (11%). Classical clinical features of hypothyroidism and hyperthyroidism were present in 9 and 2 patients respectively. All patients with hypothyroidism had positive TPO AB. Patients with thyroid dysfunction have higher values of TGs, T. Chol and LDL which was found to be statistically significant (p value <0.05). Patients with subclinical hypothyroidism have increased levels of total cholesterol and LDL levels as compared to overt hypothyroidism, but it was not found to be statistically significant. Goitre was noted in 4 patients with thyroid dysfunction among whom 2 patients had malignancy; one was follicular variant of papillary carcinoma and the other a primary thyroid Lymphoma, which is a rare tumour of thyroid gland. Conclusion:  thyroid dysfunction in elderly is not uncommon. Thyroid abnormalities were more among females (18%) than in males (7%). Clinical diagnosis is difficult to make but TFT always helps in diagnosing the disease. Subclinical state is equally common as clinical state in elderly population. As the age advances the incidence of thyroid disorders increases. Hypothyroidism was more common than Hyperthyroidism. Dyslipidaemia was noted more commonly in patients with thyroid abnormalities as compared to patients with normal TFT. A strong clinical suspicion of thyroid diseases should be considered in elderly patients who present with vague symptoms like generalised weakness, easy fatigability, lethargy and disinterest in daily activities. Elderly patients should be screened for thyroid dysfunction.

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