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March 13, 2023 10 min read

As we age, our bodies go through a natural decline, and hypothyroidism is a common condition that many elderly women face. However, with a variety of treatment options available, the question remains: is treatment always necessary? In this article, we'll take a closer look at hypothyroidism in older women, explore the factors to consider when deciding whether or not to treat and discuss the potential benefits and drawbacks of treatment options.

What is hypothyroidism?

Let's cover the basics first. Hypothyroidism, or underactive thyroid, is a condition that occurs when the thyroid gland fails to produce enough thyroid hormone. The thyroid is an endocrine gland located in your neck. Its main job is to produce thyroid hormones, thyroxine (T4) and triiodothyronine (T3), which control the metabolic rate. Thus, a deficiency or an excess of these two hormones can cause your metabolism to slow down. This can have a significant impact on your quality of life.

What are the causes of hypothyroidism in elderly women?

The most common cause of hypothyroidism, both in older and younger patients, is an autoimmune thyroid disease called Hashimoto's thyroiditis. This condition happens when your immune system, which is your body's defense against harmful agents, mistakenly attacks your thyroid gland's healthy cells and tissues.

According to a study, approximately 57% of patients over the age of 55 were diagnosed with primary hypothyroidism due to Hashimoto's thyroiditis. This is in contrast to other causes, such as thyroidectomy and radioactive iodine, which have rates of 32% and 12%, respectively.

Primary hypothyroidism or thyroid failure occurs because the thyroid gland itself is damaged, either due to autoimmune disease or other causes such as iodine deficiency. In contrast, secondary hypothyroidism is caused by a failure of the pituitary gland or hypothalamus to stimulate the thyroid gland to produce thyroid hormones. This can result from conditions such as pituitary tumors or radiation therapy to the brain.

It's also worth noting that a lack of iodine in the body can also lead to hypothyroidism since iodine is necessary for the production of thyroid hormones. Mild or moderate iodine deficiency can cause the thyroid gland to enlarge, leading to the development of a goiter. In contrast, severe iodine deficiency can result in myxedema, which is a severe form of hypothyroidism characterized by swelling of the skin and tissues.

Age-related changes in thyroid function

As people age, their thyroid function can change. Some studies have found that older people may have different levels of thyroid hormones in their blood than younger people. However, other studies have shown that these differences may actually be due to other health problems and not just aging.

Studies have also looked at how the pituitary gland, which controls the thyroid gland, functions in older people. Some studies have found that older men may have lower levels of TSH, which is a hormone that tells the thyroid gland to produce thyroid hormones. However, it's not clear why this happens.

Another factor that may contribute to changes in thyroid function with age is a decline in selenium levels. Selenium is a nutrient that helps the body make thyroid hormones, and studies have shown that supplementing with selenium may help increase thyroid hormone levels in older people.

What are the signs and symptoms of hypothyroidism in elderly women?

In general, the common symptoms of low thyroid function are similar in older and younger patients. These include:

  • Fatigue

  • Weight gain

  • Cold intolerance

  • Constipation

  • Hoarseness

  • Muscle pain

  • Cramp

  • Neurological symptoms such as depression or altered mental status from mild confusion to marked dementia.

However, elderly people who develop hypothyroidism may have typical symptoms, but these symptoms are usually less specific than those experienced by younger patients with thyroid hormone deficiency. This is because elderly patients and their doctors may attribute general complaints to other health problems that are common in older people or to the aging process itself.

A study found that fatigue and weakness were the most commonly reported symptoms by elderly patients with hypothyroidism, but they were less likely to report cold intolerance, weight gain, tingling, and muscle cramps than younger patients. Another study showed that older patients with hypothyroidism were more likely to report fatigue, difficulty breathing, and wheezing compared to younger patients. Additionally, older patients may experience neurological symptoms such as reduced taste and smell, hearing loss, and difficulty with balance.

Changes in the size and appearance of the thyroid are not commonly seen in elderly patients. Those with autoimmune thyroiditis may have a type of disorder that causes atrophy of the gland rather than goiter. In terms of cognitive function, elderly patients with hypothyroidism may score lower on tests of mental status, memory, attention, and other brain functions. Additionally, laboratory tests may show higher levels of creatinine, which can be associated with aging. Finally, pericardial effusion (fluid around the heart) is a possible complication of hypothyroidism, but it is not as common as previously believed.

What are the complications of hypothyroidism in elderly women?

Hypothyroidism in the elderly can lead to various health complications if left untreated. One complication is myxedema, or severe hypothyroidism, which causes many parts of your body, especially your legs, to swell. This condition can be life-threatening. Other complications include cardiovascular diseases, infertility, and osteoporosis.

In addition, older people with undetected and untreated hypothyroidism can develop dangerous complications during or after any surgery.

Does thyroid disease affect the life expectancy of elderly women?

As explained above, untreated or undertreated hypothyroidism can lead to various health complications. Some of these complications, like cardio

How do doctors diagnose hypothyroidism in elderly women?

Since the symptoms of hypothyroidism in the elderly can be non-specific, it can be hard to tell if it's just a normal part of aging, another medical condition with similar symptoms, or hypothyroidism. If you experience the signs and symptoms of hypothyroidism, it's a good idea to talk to your doctor about it. Doctors may ask you about symptoms and your medical and family history to diagnose hypothyroidism. They will also perform thyroid function tests.

Some of the tests your doctor will use to diagnose hypothyroidism include:

  1. Thyroid-stimulating hormone (TSH) test

The thyroid, which produces hormones that regulate metabolism and other bodily functions, is regulated by other organs in the endocrine system, including the pituitary gland and hypothalamus. The pituitary gland releases thyroid-stimulating hormone (TSH) to signal the thyroid to produce hormones. Meanwhile, the hypothalamus releases thyroid-releasing hormone (TRH) to control TSH levels.

When thyroid hormone levels are low, the pituitary gland will release more TSH to stimulate the thyroid to produce more hormones. This is because the pituitary gland is trying to compensate for the deficiency of thyroid hormones in the body.

A TSH test is used to measure the amount of serum TSH in the blood, which can indicate how well the thyroid is functioning. An abnormally high TSH level is a clear indication that the body is not producing enough thyroid hormones. This is a common sign of hypothyroidism, a condition in which the thyroid is not producing enough hormones to meet the body's needs.

  1. T4 and T3 tests

While the TSH test is the best first-line test to evaluate your thyroid function, it's always better to confirm the results by measuring your thyroid hormone concentrations.

Your doctor will perform tests to evaluate how much Free T4 (FT4) and Free T3 (FT3) are in your blood. Low levels of T4 and T3 confirm hypothyroidism diagnosis. This condition is called overt hypothyroidism or clear hypothyroidism.

Some people have high levels of serum TSH but normal levels of the T4 hormone. This condition is a type of subclinical thyroid disease called subclinical hypothyroidism. 

  1. Thyroid antibodies test

After a thyroid function test, a thyroid antibody test may be recommended by your doctor to help diagnose or rule out autoimmune thyroid conditions, such as Hashimoto's thyroiditis. If the levels of these antibodies are high, it indicates that your immune system is attacking your thyroid, causing damage and dysfunction.

It's essential to note that a thyroid antibody test is only likely to be recommended if your doctor suspects that you have an autoimmune thyroid condition. Autoimmune thyroid conditions can be challenging to diagnose, as their symptoms can be vague and similar to other conditions. Therefore, a thyroid antibody test can provide valuable information to help determine the underlying cause of your thyroid problems.

In rare cases, your doctor may also suggest a TSH-receptor antibody test to check for Graves' disease, another autoimmune thyroid condition that causes hyperthyroidism. In Graves' disease, the immune system produces antibodies that stimulate the thyroid, causing it to produce too much thyroid hormone, resulting in hyperthyroidism.

However, TSH-receptor antibodies are not always reliable in detecting Graves' disease, as the condition can be challenging to diagnose due to its varying symptoms. Furthermore, Graves' disease is more likely to cause hyperthyroidism than hypothyroidism, making the TSH-receptor antibody test a less common choice.

Does hypothyroidism in the elderly need to be treated?

There is some controversy within the medical community regarding whether or not older patients with hypothyroidism should receive treatment. Some studies suggest that older patients with mild or subclinical hypothyroidism may not benefit from thyroid hormone replacement therapy, as they may have a higher risk of adverse effects such as heart problems and fractures. However, other studies suggest that treatment can be beneficial for older patients, especially those with more severe symptoms or lower TSH levels.

The American Thyroid Association recommends that older patients with TSH levels above the normal reference range, but less than 10 mIU/L, should be considered for thyroid hormone replacement therapy based on individual clinical circumstances.

Ultimately, the decision to treat hypothyroidism in older patients should be made on a case-by-case basis, taking into account the patient's age, overall health, and individual symptoms. It's important to consult with a healthcare provider who can provide personalized care and guidance based on each patient's unique situation.

What are the treatment options for hypothyroidism in the elderly?

The treatment for hypothyroidism in the elderly is similar to those in young patients. The standard treatment for hypothyroidism is pure synthetic thyroxine, also known as levothyroxine. This medication, taken once a day by mouth, can fully replace the function of the thyroid and treat the symptoms of hypothyroidism in most patients. It's a great option for folks of all ages, including older patients who may need a slower approach to treatment.

However, not everybody may benefit from levothyroxine since it only contains one thyroid hormone: thyroxine (T4). T4 is the inactive thyroid hormone, meaning it needs to be converted to triiodothyronine (T3) in order for the body to use it. Unfortunately, the conversion process doesn't always occur properly, especially in older patients. Thus, adding T4 won't help you get any better.

If this is the case for you, natural desiccated thyroid (NDT) may be the way to go. In fact, a study has shown that most hypothyroid patients prefer NDT over levothyroxine. It's also popular among people who prefer a more natural option.

NDT is derived from the thyroid glands of pigs and contains a combination of T4 and T3 hormones.

The only downside of NDT is that it can be hard to find in many pharmacies in the US. Fortunately, you can now buy VitaliThy, a natural desiccated thyroid you can buy online. This NDT supplement contains all the hormones your thyroid naturally produces, such as T4, T3, T2, T1, and Calcitonin. Plus, it's free from common allergens like lactose, gluten, shellfish, fish, and eggs.

Dose of thyroid hormone replacement medication for elderly patients

When it comes to treating hypothyroidism in older patients, it's important to take things slow and steady. Whichever treatment option you end up choosing, full hormone replacement doesn't need to happen rapidly, as it can put stress on the heart and central nervous system. Instead, hormone treatment is usually started with a partial daily dose, giving the body time to adjust to increasing levels of thyroid hormone. It's important to keep an eye out for any potential side effects, like angina, shortness of breath, confusion, or changes in sleep habits, and notify your doctor if any occur.

Treatment for hypothyroidism may start with a low dose of thyroid replacement medication and gradually increase every 4-6 weeks until blood tests show a return to normal thyroid hormone and thyroid-stimulating hormone levels. Older patients who don't have heart disease, stroke, or dementia may be able to start on larger doses and move more quickly to full hormone replacement. If any concerning symptoms arise, the dose of thyroid replacement medication may need to be decreased and gradually increased over several months.

What if I take other medicine along with my thyroid medicine?

Have you ever wondered what would happen if you took other medications along with your thyroid medication? Well, it turns out that drug interactions can occur in the elderly who are being treated with other drugs for comorbidities.

For instance, taking about 2000 mg of calcium carbonate can hinder the maximum absorption of thyroid hormone. Consequently, elderly patients might need a higher dose of thyroid medication. Similarly, ferrous sulfate, aluminum hydroxide, sucralfate, cholestyramine, colestipol, and raloxifene can also decrease the absorption of the thyroid replacement medication..

Postmenopausal women often suffer from a lack of the female sex hormone, estrogen, which can lead to hormonal disorders. Although estrogen replacement therapy can help, it can also increase the need for thyroid hormone if taken with thyroid medication.

Likewise, hypothyroid patients taking medications such as carbamazepine, phenytoin, phenobarbital, or rifampin need higher doses of thyroid drugs as they often increase the thyroid hormone metabolism, especially thyroxine. On the other hand, women with breast cancer treated with fluoxymesterone may require significantly lower doses of thyroid hormone.

The truth is many medications can react with thyroid medications and cause adverse side effects. Therefore, it is crucial to inform your doctor of all other medical conditions for which you are being treated.

Conclusion: Hypothyroidism in the elderly should be treated

As we age, it's important to keep our health in check. One aspect of health that often goes overlooked is the thyroid, which plays a critical role in regulating our body's metabolism. When the thyroid isn't functioning properly, it can lead to a condition known as hypothyroidism, which is one of the most common thyroid disorders in the world. Fortunately, there are treatment options available to help manage this condition, especially in the elderly.

The mainstay of hypothyroidism treatment is levothyroxine, a synthetic form of the thyroid hormone. But did you know that there is a natural alternative called natural desiccated thyroid? Many people prefer this option because it is derived from animal thyroid glands and contains a combination of hormones, including T3 and T4. Plus, you can buy desiccated thyroid online: VitaliThy, making it easier than ever to get the treatment you need.

If you're an elderly person struggling with hypothyroidism, natural desiccated thyroid could be the solution you've been looking for.

Wojciech Majda
Wojciech Majda

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