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Thyroid Status and Survival in Old Age
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To The Editor: The study by Dr Gussekloo and colleagues1 determined that the oldest old with abnormally high levels of thyrotropin do not experience adverse effects and may have a prolonged life span. I would like to add an additional conclusion and a possible study limitation.
"Normal" laboratory result reference ranges are calculated by either the statistical or epidemiologic method.2 The more commonly used statistical method defines a reference range as 2 SDs above and below the mean in a population of apparently disease-free individuals, usually not stratified by age or sex. In the epidemiologic method, abnormal values are defined as being associated with adverse consequences.
Since Gussekloo et al were not able to find adverse consequences in the oldest old with levels of thyrotropin that are classified as high, a reasonable conclusion would be that those thyrotropin levels should be considered clinically normal, and reference standards for thyrotropin should . . . [Full Text of this Article]
Ronald R. Scobbo, MD
rrs@ntelos.net
Department of Medicine
West Virginia University School of Medicine
Morgantown
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