Hypothyroidism in elderly and senile patients
E.N. Dudinskaya, O.N. Tkacheva
Pirogov Russian National Research Medical University, Moscow
Among the elderly generation, subclinical dysfunction of the thyroid gland (TG) is more common than overt forms of the disease; therefore, the prevalence of subclinical hypothyroidism increases with age and ranges from 3 to 16% in people over 60 years of age.
Features of the hypothyroidism treatment in the elderly involve a cautious approach, proper assessment and selection of the appropriate strategy. Therapy of hypothyroidism in the elderly is a difficult task due to concomitant diseases, polypragmasy, features of the functional and psychosocial status of patients.
Conducting adequate replacement therapy for hypothyroidism contributes not only to improving the patient’s somatic condition and preserving the functional status of an elderly patient, but also serves to prevent numerous organ disorders arising in the setting of decreased thyroid function. The quality of life of patients with hypothyroidism who constantly receive adequate replacement therapy is slightly different from that of those without hypothyroidism, and hypothyroidism itself becomes as a way of life for the patient, not as a disease.
This article describes the aspects of clinical symptoms and diagnosis of hypothyroidism in the elderly and senile patients, provides a definition of hypoglycemia. The main approaches to the treatment of hypothyroidism in elderly patients are highlighted.
Key words: hypothyroidism, subclinical dysfunction of the thyroid gland, aging, levothyroxine sodium, presenile age.
For citation: Dudinskaya E.N., Tkacheva O.N. Hypothyroidism in elderly and senile patients // RMJ. Medical Review. 2018. № 8(I). P. 14–18.
References
1. Barbesino G. Drugs affecting thyroid function // Thyroid. 2010. Vol. 20. № 7. P.763–770.
2. Gesing A., Lewiński A., Karbownik-Lewińska M. The thyroid gland and the process of aging: what is new? // Thyroid Res. 2012. № 5. [Электронный ресурс]. URL: http://dx.doi.org/10.1186/1756–6614–5–6 (дата обращения: 13.01.2018).
3. Заболевания щитовидной железы в схемах: информация для специалистов здравоохранения / под ред. В.В. Фадеева, Г.А. Мельниченко, И.И. Дедова. М.: Никомед. 2008. 26 с. [Zabolevanija shhitovidnoj zhelezy v shemah: informacija dlja specialistov zdravoohranenija / pod red. V.V. Fadeeva, G.A. Mel’nichenko, I.I. Dedova. M.: Nikomed. 2008. 26 s. (in Russain)].
4. TIROSINT (levothyroxine sodium) capsules, for oral use // U.S. Food and Drug Administration, 2017. [Электронный ресурс]. URL: https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021924s013lbl.pdf (дата обращения: 13.01.2018).
5. Прохорович Е.А., Ткачева О.Н., Адаменко А.Н. Особенности клинического течения и лечения артериальной гипертонии у женщин // Трудный пациент. 2006. Т.4. № 8. С.13–16 [Prohorovich E.A., Tkacheva O.N., Adamenko A.N. Osobennosti klinicheskogo techenija i lechenija arterial’noj gipertonii u zhenshhin // Trudnyj pacient. 2006. T.4. № 8. S.13–16 (in Russain)].
6. Фадеев В.В. По материалам клинических рекомендаций европейской тиреоидной ассоциации по использованию комбинированной терапии L-T4 + L-T3 в лечении гипотиреоза // Клиническая и экспериментальная тиреоидология. 2012. Т.8, № 2. С.14–18 [Fadeev V.V. Po materialam klinicheskih rekomendacij evropejskoj tireoidnoj associacii po ispol’zovaniju kombinirovannoj terapii L-T4 + L-T3 v lechenii gipotireoza // Klinicheskaja i jeksperimental’naja tireoidologija. 2012. T.8. № 2. S.14–18 (in Russain)].
7. Эндокринология: учебник для вузов / под ред. Дедова И.И, Мельниченко Г.А., Фадеева В.В. 3-е изд., перераб. и доп. М.: Литтерра. 2015. 416 с. [Jendokrinologija: uchebnik dlja vuzov / pod red. Dedova I.I, Mel’nichenko G.A., Fadeeva V.V. 3-e izd., pererab. i dop. M.: Litterra. 2015. 416 s. (in Russain)].
8. McQuade C., Skugor M., Brennan D.M. et al. Hypothyroidism and moderate subclinical hypothyroidism are associated with increased all-cause mortality independent of coronary heart disease risk factors: a PreCIS database study // Thyroid. 2001. Vol. 21. № 8. P.837–843.
9. Devdhar M., Drooger R., Pehlivanova M. et al. Levothyroxine replacement doses are affected by gender and weight, but not age // Thyroid. 2011. Vol. 21. № 8. P.821–827.
10. Kubota S., Fujiwara M., Hagiwara H. et al. Multiple thyroid cysts may be a cause of hypothyroidism in patients with relatively high iodine intake // Thyroid. 2010. Vol. 20. № 2. P.205–208.
11. Bahn Chair R.S., Burch H.B., Cooper D.S. et al. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists // Thyroid. 2011. Vol. 21. № 6. P.593–646.
12. Morshed S.A., Latif R., Davies T.F. Characterization of thyrotropin receptor antibody-induced signaling cascades // Endocrinology. 2009. Vol. 150. № 1. P.519–529.
13. Boucai L., Hollowell J.G., Surks M.I. An approach for development of age-, gender-, and ethnicityspecific thyrotropin reference limits // Thyroid. 2011. Vol. 21. № 1. P.5–11.
14. Pearce S.H., Brabant G., Duntas L.H. et al. ETA Guideline: management of Subclinical Hypothyroidism // Eur. Thyroid J. 2013. Vol. 2. T.4. P.215–228.
15. Rayman M.P., Thompson A.J., Bekaert B. et al. Randomized controlled trial of the effect of selenium supplementation on thyroid function in the elderly in the United Kingdom // Am. J. Clin. Nutr. 2008. Vol. 87. T.2. P.370–378.
16. Razvi S., Weaver J.U., Vanderpump M.P. et al. The incidence of ischemic heart disease and mortality in people with subclinical hypothyroidism: reanalysis of the Whickham Survey cohort // J. Clin. Endocrinol. Metab. 2010. Vol. 95. № 4. P.1734–1740.
This work is licensed under a Creative Commons «Attribution» 4.0 License.
Previous article
Next article
