Document Detail

Hypothyroidism and hyperthyroidism in the elderly.
MedLine Citation:
PMID:  1588294     Owner:  NLM     Status:  MEDLINE    
Thyroid disease in the elderly can be easily overlooked. Symptoms too often are explained away as normal processes of aging. Development of unstable illness, especially cardiac disease, is a frequent mode of presentation. One symptom or one clinical feature of thyroid disease in the elderly may be overwhelming in its presentation, as in apathetic hyperthyroidism, thyroid myopathy, depression and dementia. Physical examination of the thyroid gland can be helpful but in a high percentage of older patients the gland is normal to palpation. The treatment of hypothyroidism is straightforward. Only myxedema coma requires large doses of levothyroxine parenterally; all other forms of hypothyroidism are treated with oral levothyroxine. The dose is started very low and increased gradually over months. The euthyroid state is achieved gradually and safely. Hyperthyroidism can be treated by several modalities. In the unstable elderly patient, antithyroid medication can quickly produce a euthyroid state. When the patient is stable, further decisions can be made regarding definitive therapy. Radioactive iodine therapy is well-tolerated and effective. On occasion, a second course of therapy is needed to suppress hyperthyroidism. Close follow-up of all patients ever having received this therapy is needed to identify the development of hypothyroidism. Surgical thyroid ablation may be necessary in patients who fail to respond to radioactive iodine therapy. Abnormalities associated with unresolved thyromegaly, dysphagia, or tracheal compression may require surgical intervention. If suspicion exists that the gland is cancerous, surgical intervention is warranted.
M J Mintzer
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Journal of the Florida Medical Association     Volume:  79     ISSN:  0015-4148     ISO Abbreviation:  J Fla Med Assoc     Publication Date:  1992 Apr 
Date Detail:
Created Date:  1992-06-22     Completed Date:  1992-06-22     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  7505604     Medline TA:  J Fla Med Assoc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  231-5     Citation Subset:  IM    
University of Miami School of Medicine.
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MeSH Terms
Hyperthyroidism* / diagnosis,  therapy
Hypothyroidism* / diagnosis,  therapy

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