Diagnosis and treatment of hypothyroidism in old people

A new old challenge
  • Antonio Maria Borzì
  • Antonio Biondi
  • Francesco Basile
  • Marco VacanteEmail author
review article



To review the diagnosis and the treatment of both subclinical and overt hypothyroidism in old people, which could represent a challenge for the clinicians.


Narrative literature review. An extensive literature search was performed using the databases of Scopus, Medline through PubMed, and Google Scholar from January 1975 to May 2019. The search terms were “hypothyroidism,” “older adults,” “elderly,” and “myxedema.”


Hypothyroidism is more common among older subjects in comparison to the younger counterparts. The hypothalamic-pituitary-thyroid axis and its hormones undergo significant changes due to the physiological aging process. For a correct diagnosis of hypothyroidism in old people clinicians must take such age-related changes into account.


The administration of replacement therapy in older adults should consider frailty, polypharmacy and a high risk to develop overtreatment symptoms. On the other hand, older patients with untreated or undertreated hypothyroidism may develop a state of myxedema coma.


Aged Thyroid L‑Thyroxine Frailty Therapeutics 


Compliance with ethical guidelines

Conflict of interest

A.M. Borzì, A. Biondi, F. Basile, and M. Vacante declare that they have no competing interests.

Ethical standards

For this article no studies with human participants or animals were performed by any of the authors. For this type of study, informed consent is not required.


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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of General Surgery and Medical-Surgical SpecialtiesUniversity of CataniaCataniaItaly

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