Medicine: Subclinical hypothyroidism in the elderly

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  • 2018 03 Medicine, Subclinical hypothyroidism in elderly
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Treating subclinical hypothyroidism in the elderly doesn’t improve symptoms.
What are the possible symptoms of subclinical hypothyroidism? They can for example be fatigue, or decrease of pulse and blood pressure, the nervous system and mental faculties are not as active as before, one feels cold, one puts on weight, one loses the desire for sex and one feels more depressive than before.
In the largest clinical study on this question to date, there were no differences at all between a real treatment and placebo. The study convincingly showed that treating subclinical hypothyroidism in the average older adult of either sex does not improve symptoms.
And what is subclinical hypothyroidism? Hypothyroidism is an underactive thyroid, i.e. a suboptimally functioning thyroid. And subclinical in this context: a laboratory diagnosis. One lab value is increased, TSH, but another lab value, free T4, is just sufficient or even completely normal.
A well-known professor summarises: Treatment should only be contemplated in patients when TSH levels are persistently high, free T4 is near the lower limit of normal, and bothersome symptoms are present. Even so, the value of treatment is unproven.
Plus, have your TSH measured several times at regular intervals if one day you should be diagnosed with subclinical hypothyroidism. Because maybe the subclinical hypothyroidism simply will go away by itself, as happened often in the run-up phase of this study.

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