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What you should know about
thyroid disease & aging
what is
thyroid disease
Thyroid disorders occur more commonly with increasing
age. If you have a thyroid problem, it doesn’t necessarily
mean that you will miss out on a happy and healthy life.
This pamphlet provides information about the role of your
thyroid. It also provides information about the symptoms,
causes, and treatment of thyroid diseases that are
common in older patients. As with any healthcare issue,
always talk to your health provider about your
particular situation.
What thyroid diseases occur
in older patients?
What is the thyroid,
and why is it important?
• Hypothyroidism – Not enough thyroid hormone
is produced The thyroid is an endocrine gland that plays a key role in
regulating growth, development, and normal function of
the body.1 It is a butterfly-shaped gland located in the front
of your neck. The thyroid can affect your heart rate, your
emotional state, your feelings of tiredness and hunger, and
the condition of your skin and hair. In fact, your thyroid
influences most cells in your body.
With thyroid disease, thyroid hormones are either
over-produced or under-produced. Symptoms may differ
in older patients compared to younger adult patients.2
Treatment may need to be adjusted for the effects of age,
the presence of other health conditions, and medications
being taken. Diseases of the thyroid gland include1,3:
• Hashimoto’s disease – An autoimmune disease
that causes the thyroid to produce too little
thyroid hormone, causing hypothyroidism
• Hyperthyroidism – Too much thyroid hormone
is produced
• Graves’ disease – An autoimmune disease that
causes the thyroid to produce too much thyroid
hormone, causing hyperthyroidism
Your thyroid controls your body’s functions by making
several hormones, including thyroxine (T4), which is
converted to triiodothyronine (T3).1 If you do not get
enough iodine in your diet, your thyroid cannot produce
enough T3 and T4. The amounts of T3 and T4 released into
the bloodstream:
• Goiter – Enlargement of the thyroid gland
• Regulate the body’s ability to turn food
into energy
Hypothyroidism and aging
• Affect rates of tissue growth
People with hypothyroidism may experience some of these
symptoms or may not notice symptoms at all. You may
have few or no symptoms or you may mistake symptoms
for the expected effects of aging.2 With an examination,
your doctor may detect additional signs of the disease such
as slowed heart rate and goiter. Signs and symptoms of
hypothyroidism include3,4:
• Affect the function of organ systems
throughout the body
The amount of thyroid hormones released by the thyroid
gland is monitored and controlled by the pituitary gland
which releases thyroid-stimulating hormone (TSH) when
the thyroid hormone levels are too low.1 When your thyroid
is functioning normally, TSH levels are relatively low.
Thyroid gland
Trachea
(Windpipe)
• Thyroid nodules – Growth of thyroid tissue causing
circular or oval-shaped lumps in the thyroid gland
• Thyroid cancer – Growth of the thyroid gland, either
goiter or thyroid nodules, that becomes cancerous
• Depression
• Goiter
• Decreased concentration • Slow heartbeat
• Puffy face
• Dry or yellow skin
• Coarseness or loss of hair • Infertility
• Hoarseness
• Irregular or heavy menses
• Muscular pain
• Constipation
• Brittle nails
• Reflex delay
• Cold intolerance
• Weight gain from
• Cholesterol abnormalities fluid retention
• Fatigue
• Mental impairment
1
What you should know about
thyroid disease & aging
thyroid function and
hypothyroidism
How do I know if I have hypothyroidism?
Hyperthyroidism and aging
If you have a family history of thyroid disease or if you
report certain symptoms to your doctor, he or she can
use several simple laboratory tests to check whether your
thyroid gland is functioning normally. Your doctor may
order a TSH test, which is the recommended test for
evaluating thyroid hormone levels.3 It measures the level
of thyroid-stimulating hormone (TSH), a hormone that
controls the amount of thyroid hormone (T4) produced.1
Another test that may be used measures the amount
of thyroxine (T4), circulating in your blood. Of these, the
TSH test is recognized to be the most sensitive test for
detecting too much or too little thyroid hormone.3
Generally, the symptoms of hyperthyroidism are associated
with the body “speeding up.” People with hyperthyroidism
may experience some of these symptoms or they may
not notice any symptoms at all. Older people, especially,
seem to have fewer hyperthyroid symptoms.2 With an
examination, your doctor may detect additional signs of
the disease, such as rapid heartbeat, goiter, eye problems,
or thyroid tenderness. Signs and symptoms of
hyperthyroidism include3:
• Mild hypothyroidism – TSH levels are elevated,
but the thyroid is working harder to produce a
normal amount of T4.1 Signs and symptoms may
or may not occur.
• Overt hypothyroidism – If your thyroid is unable
to make enough thyroid hormone, T4 levels fall
below the normal range as TSH levels continue to
elevate.1 Signs and symptoms are likely to occur.
If further testing is needed, your doctor may want to
see results of a thyroid scan, an image of your thyroid
used to determine whether your whole thyroid or if
specific parts are enlarged and not functioning properly.
Another option is for your doctor to prescribe a radioactive
iodine uptake test. This test will measure how much
iodine is absorbed by your thyroid gland and where it
accumulates. A thyroid antibody test will determine if your
immune system is attacking your thyroid gland, which
occurs in Hashimoto’s disease, the most common cause
of hypothyroidism.1
How is hypothyroidism treated?
Your physician may prescribe medication that replaces
the thyroid hormone that the body normally produces.3
Through a series of blood tests every 6 to 8 weeks, your
doctor will decide which precise dose is appropriate for
you. Once your doctor has prescribed your appropriate
dose, it’s important to remain consistent to avoid overor under-replacement. Over-replacement may lead to
an increased risk of osteoporosis or heart problems.
Under-replacement may lead to symptoms such as fatigue,
mental dullness, or depression. Your doctor will monitor
your disease with periodic TSH tests and may adjust your
medication as needed throughout the course of your life.
• Nervousness
• Mental disturbances
• Sleep disturbances
• Vision disturbances
• Thyroid enlargement
• Rapid heartbeat
• Weight loss
• Shortness of breath
• Heat intolerance
• Tremor
• Sudden paralysis
• Alterations in appetite
• Frequent bowel movements
• Menstrual disturbance
• Impaired fertility
• Leg swelling
• Fatigue and muscle weakness
How do I know if I have hyperthyroidism?
If you have a family history of thyroid disease or you report
certain symptoms to your doctor, he or she can use several
simple laboratory tests to check whether your thyroid
gland is functioning normally. Your doctor may order the
TSH test, which measures the level of thyroid-stimulating
hormone (TSH), a hormone that controls the amount of
thyroid hormone (T4) produced.1,3 Another test that may be
used measures the amount of the main thyroid hormone
(T4) circulating in your blood. Of these, the TSH test is
recognized to be the most sensitive test for detecting too
much or too little thyroid hormone.1,5
• Mild hyperthyroidism – TSH levels fall below
the normal range and T4 levels are normal.
Signs and symptoms may or may not occur.
• Overt hyperthyroidism – Your thyroid makes too
much thyroid hormone. T4 levels rise above the
normal range while TSH levels fall below.5
Signs and symptoms are likely to occur.
2
What you should know about
thyroid disease & aging
thyroid function and
managing
If further testing is needed, your doctor may want to see
results of a thyroid scan, an image of your thyroid used to
determine if your whole thyroid or if specific parts of your
thyroid, or nodules, are hyperactive. Another option, your
doctor may prescribe a radioactive iodine uptake test.
This test will measure how much iodine is absorbed by
your thyroid and where it accumulates.
How can I manage the health
of my thyroid?
hyperthyroidism
How is hyperthyroidism treated?5
The treatment for hyperthyroidism varies between patients.
If you have hyperthyroidism, your age, severity of disease,
overall state of health, and other factors all play a role in
what your doctor chooses for you. One or more of the
following treatments may be used:
ntithyroid drugs. These drugs block the ability of the
A
thyroid to produce thyroid hormone. They do not damage
the thyroid gland and may be used for short- or long-term
treatment. Antithyroid drugs are also used to prepare a
patient for treatment with radioactive iodine or for surgery.
Radioactive iodine. This treatment, usually a pill taken
once by mouth, damages or destroys thyroid cells that
produce excess thyroid hormone. This process may take
a few weeks or months. The thyroid gland is reduced
in size, and the amount of hormone produced is also
reduced. People given this treatment commonly become
hypothyroid, which can be treated with medication.4
Surgery. Surgery may remove all or part of the thyroid
to cure hyperthyroidism. This treatment often results in
hypothyroidism. To maintain adequate levels of thyroid
hormone in the body, daily treatment with thyroid hormone
replacement will be required after surgery.5
Beta-blockers.5 These drugs help reduce some of the
symptoms of hyperthyroidism, such as rapid heart rate
and nervousness.
my thyroid
1.Pay attention to how you feel, and report symptoms
to your doctor. If you are a woman, older than age 60,
have an autoimmune disease (such as type 1 diabetes
or rheumatoid arthritis), have a family history of thyroid
disease or have had surgery or radiation therapy, you
may need to be tested more frequently.
2.If you suspect that you may have thyroid disease,
ask your doctor about a TSH test. If you have
concerns and symptoms of thyroid disease,
you should discuss them with your doctor.
3.If you have thyroid disease, follow your doctor’s
directions. Take your medications exactly as
prescribed by your doctor.
4.Have your thyroid function checked every year.
An annual TSH test can confirm if your thyroid is
functioning normally.
Tips on taking medication
If you have hyperthyroidism that is treated with surgery or
radioactive iodine, you may develop hypothyroidism after
treatment. If you become hypothyroid and thyroid hormone
replacement is prescribed, consider the following advice:
1.Take your medication every day, as prescribed.
2.Take your medications at the same time every day.
If you’re taking other medications, prescribed or
over-the-counter products, including vitamin
supplements, consult with your doctor.
3.Tell your doctor if you stop taking one of your
regular medications or start taking a new one.
Therapy for hyperthyroidism in older people must
be closely monitored for its potential effects on other
body systems, including the heart.2 It is important to follow
your doctor’s directions and to have your thyroid hormone
levels checked regularly to see if your medication needs
adjustment.
3
What you should know about
The take-home message
Having a thyroid disease may require you to
take medications, undergo special treatment
procedures, and see your doctor for frequent
follow-up checks.
References: 1. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the National
Institutes of Health (NIH). Thyroid function tests. National Endocrine and Metabolic Diseases Information
Service Web site. http://endocrine.niddk.nih.gov/pubs/thyroidtests. Accessed July 15, 2011. 2. Thyroid
disease in the older patient. American Thyroid Association Web site. http://www.thyroid.org/patients/
patient_brochures/older_patient.html. Accessed July 15, 2011. 3. AACE Thyroid Task Force. American
Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment
of hyperthyroidism and hypothyroidism. Endocrinol Pract. 2002;8:457-469. 4. National Institute of Diabetes
and Digestive and Kidney Diseases (NIDDK) and the National Institutes of Health (NIH) Hypothyroidism.
National Endocrine and Metabolic Diseases Information Service Web site. http://endocrine.niddk.nih.gov/
pubs/Hypothyroidism/. Accessed July 15, 2011. 5. Hyperthyroidism. American Thyroid Association
Web site. http://www.thyroid.org/patients/brochures/Hyper_brochure.pdf. Accessed July 15, 2011.
This pamphlet is provided to you by Abbott.
©2011 Abbott Laboratories Abbott Park, IL 60064 605-640818 June 2011 Printed in U.S.A.
thyroid disease & aging