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Comparison of the Average Dose of Thyroid Replacement Among Genders & Across
Different Age Groups
Tina Kochupurackal, D.O., Barry Hoffman, D.O.
Rowan University SOM, Department of Family Medicine, Stratford, NJ 08084
ABSTRACT
Comparison of Average Thyroid Dosing in Men & Women in Various Age Groups
Background and Hypothesis:
The objective of this study was to determine if patients
truly required higher doses of thyroid repletion with
increasing age. This study hypothesized that females
require higher doses
of thyroid repletion to reach
BACKGROUND
euthyroid state. It was also hypothesized that females
within older age brackets will require greater thyroid
repletion with thyroid hormone supplementation than
younger females or their male counterparts within
similar age brackets.
120
Women
100
80
60
40
20
0
40s
Methods:
An IRB-approved chart review was pursued using data
from the electronic medical charts of patients seen
within the past year at the four Rowan-SOM Family
Medicine offices. Electronic charts of patients on
thyroid hormone replacement were reviewed. Charts
were
chosen
regardless
of
demographic
characteristics such as age, gender, or ethnicity.
However, charts of patients whose TSH levels were not
within normal limits (0.4-4.0mIU/L) were excluded, as
those patients had not reached a euthyroid state.
Results:
Five hundred sixty-seven charts were reviewed after
removing patients with TSH out of range or those that
had not been checked within the past year. Four
hundred fifty-eight female charts and 109 male charts
were noted. Thyroid repletion dosing in females were
noted to increase METHOD
until age 40-50’s, and then
subsequently decline.
Conclusion:
Data review revealed a bell shaped distribution in the
thyroid replacement dosing among females – reaching
its peak at an age range of approximately 40 to 50
years old. There was also a noted decrease in thyroid
dosing in females beyond this age bracket, disproving
our hypothesis. Results suggested that possible
starting doses for thyroid medication repletion may
follow a bell-shaped curve, with higher doses needed
for females between 40-50 years old. This knowledge
can lead to better patient care and surveillance of
disease – allowing physicians to better understand
TSH patterns over the course of a patient’s lifetime.
Men
50s
60s
70s
80s
90s
567 charts were reviewed – consisting of 458 female patients & 109 male patients. Women
appear to require higher thyroid dosing compared to their male counterparts in their 40s,
70s, 80s, and 90s.
Average Thyroid Dosing in Women at Various Ages
102
98
94
90
86
82
78
74
70
20's
30s
40s
50s
60s
70s
80s
90s
Thyroid repletion dosing in females are noted to increase until age 40-50s & then
subsequently decline. This peak in thyroid dosing may very well represent
premenopausal / menopausal ages in females.
References
1. Aoki Y, Belin RM, Clickner R, et al. Serum TSH and total T4 in the United States population and their association with participant characteristics: National Health and Nutrition
Examination Survey (NHANES 1999-2002). Thyroid. 2007 Dec. 17 (12):1211-23.
2. Devdhar, M., Drooger, R., Pehlivanova, M., Singh, G., & Jonklaas, J. (2011). Levothyroxine Replacement Doses Are Affected by Gender and Weight, But Not Age. Thyroid, 21(8), 821-827.
Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3148125/#B28
3. Jonklaas, J. (2010). Sex and Age Differences in Levothyroxine Dosage Requirement. Endocrine Practice, 16(1), 71-79. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/19833578
4. Orlander, P. R., MD. (n.d.). Hypothyroidism. Retrieved February 08, 2016, from http://emedicine.medscape.com/article/122393-overview#a5
5. Roth, D. S., MD. (2014). Diagnosis of and screening for hypothyroidism in nonpregnant adults. Retrieved February 08, 2016, from http://www.uptodate.com/contents/diagnosis-of-andscreening-for-hypothyroidism-in-nonpregnant-adults
6. Sawin, C. T. (1985). The Aging Thyroid. Arch Intern Med Archives of Internal Medicine, 145(8), 1386. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/4026469
7. Wisse, B., MD. (2014, May 10). TSH test: MedlinePlus Medical Encyclopedia. Retrieved February 08, 2016, from https://www.nlm.nih.gov/medlineplus/ency/article/003684.htm
Acknowledgement
The authors want to acknowledge the
Rowan IRB and the Department of
Family Medicine for their support with
the Research Project.