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Thyroid Problems and Older Adults

Thyroid disease is more common as we age — and more difficult to diagnose

Jennifer Rhodes-Kropf, M.D.'s picture
Thyroid Problems and Older Adults
Thyroid Problems and Older Adults

Your 68-year-old mother isn’t acting like herself lately — she seems a little down and unfocused. Is she depressed? Are these early symptoms of dementia? You may be surprised to learn that thyroid disease could be another possible cause.

Thyroid disease is fairly common, and occurs most often in aging women. It can be difficult to diagnose in the elderly because the symptoms can mimic those of many other diseases — or the normal signs of aging. 

What is the thyroid? Located in the neck, this butterfly-shaped gland produces a hormone that controls the metabolism: It helps the body use energy and stay warm, and keeps organs like the brain and heart functioning properly.

Thyroid disease falls into two main categories: Hyperthyroidism, or excessive production of thyroid hormone; and hypothyroidism, or reduced production of thyroid hormone:

Hyperthyroidism tends to make the body’s functions speed up; in older people, cardiac problems are the most common symptom. Hyperthyroidism can be life-threatening in the elderly, and requires prompt attention.

Hyperthyroidism is usually caused by Graves disease; other causes include inflammation of or growths on the thyroid, and eating too much iodine-containing food. The main treatments are medication to suppress the gland, surgery to remove it and radioactive iodine to destroy it. If the gland is removed or destroyed, the patient will need thyroid replacement hormone pills for the rest of her life.

Hypothyroidism is very common in patients over 60 years of age and is more likely to occur with advancing age — up to 1 in 4 patients in nursing homes may have undiagnosed hypothyroidism. The disease is usually caused by inflammation and swelling of the thyroid gland (known as Hashimoto's disease or chronic thyroiditis).

The signs and symptoms of hypothyroidism include weight gain, sensitivity to cold, dry skin, constipation, and slowed speaking and/or thinking. Thyroid replacement medication, usually taken for life, is the main treatment for hypothyroidism, and in most cases returns thyroid hormone levels to normal.

We’d like to hear from you! Are you living with a thyroid condition? Share your experiences with us by commenting below.

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Geriatrician

Dr. Rhodes-Kropf, is a staff geriatrician at HRC. She received her medical degree from the University of North Carolina and completed her internal medicine internship at the Hospital of the University of Pennsylvania and her residency in internal medicine at Cornell University/New York Presbyterian Medical Center. Dr. Rhodes-Kropf, an instructor in medicine at Harvard Medical School, completed a geriatrics fellowship at Mount Sinai Hospital.

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