The Aging Thyroid
The Use of Thyroid Hormone in Older Persons
- Clark T. Sawin, MD;
- Andrew Geller, MD;
- Jerome M. Hershman, MD;
- William Castelli, MD;
- Pamela Bacharach
- From the Medical Service, Boston Veterans Administration Medical Center (Drs Sawin and Geller and Ms Bacharach), and the Department of Medicine, Tufts University School of Medicine (Dr Sawin), Boston, Mass; the Medical Service, Wadsworth Veterans Administration Medical Center, and the Department of Medicine, UCLA School of Medicine, Los Angeles, Calif (Dr Hershman); and the Framingham Heart Study, National Heart, Lung, and Blood Institute, Framingham, Mass (Dr Castelli).
Abstract
The overall prevalence of thyroid hormone use in an unselected population of older adults (n = 2575; average age, 68.6 years) was 6.9% (10.0% in women and 2.3% in men). Eighty-one percent of women taking it were doing so for appropriate indications, eg, hypothyroidism, while 12% were not, eg, for obesity or high serum cholesterol; more men (29%) were taking it inappropriately. Inappropriate use was associated with desiccated thyroid more than with thyroxine. After follow-up averaging 6.9 years, 58% of inappropriate users were still taking it. Underuse also occurred. Thirty-seven percent of those definitely hypothyroid had a clearly elevated serum thyrotropin level (>10 mU/L) despite thyroid therapy. Thyroid therapy is common in the elderly; most is appropriate. When inappropriate use occurs, it is more common in men and more often associated with desiccated thyroid, still commonly used in this age group. In chronic users of thyroid hormone, it is important to review currently appropriate indications and to measure serum thyrotropin levels to assess the adequacy of treatment of primary hypothyroidism.
(JAMA. 1989;261:2653-2655)
Footnotes
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Reprint requests to Veterans Administration Medical Center, 150 S Huntington Ave, Boston, MA 02130 (Dr Sawin).
