Abstract
The prevalence of thyroid disorders was investigated in 466 (403 female, 63 male) subjects over the age of 60 years (79.2 ± 7.5 years; \({/bar x}\) ± SD) from the general population in an area of iodine deficiency. In addition to thyroid hormone assays, thyroid antibodies and urinary iodine excretion were determined. In cases with thyroid dysfunction, ultrasound investigations were performed. p]Twenty-two of the 466 subjects (4.7%) showed hyper- or hypothyroidism; 7 subjects were hyperthyroid (1.5%), 5 had primary hypothyroidism (1.1%), and 10 showed “subclinical” hypothyroidism (2.2%). The latter constellation is defined as an elevation of thyrotropin (TSH) with normal values for thyroxine and triiodothyronine. Most subjects with hyperthyroidism had a goiter by palpation (6/7); thyroid volume by ultrasound (median) was 26.2 mL with an inhomogeneous echo pattern in 6 of the 7 subjects. In 4 cases, a rise in urinary iodine excretion was documented; none had TSH-receptor antibodies. Most subjects with overt or subclinical hypothyroidism had a homogeneous or low-echogenic pattern by ultrasound; thyroid volume (median) was 12.9 mL and 12.7 mL, respectively. By palpation, 8 of the 15 subjects had no goiter. In general, these persons had no rise in urinary iodine excretion (11/13), but most showed an elevation of antibodies against the microsomal antigen and/or thyroglobulin (11/15). In summary, thyroid disorders in the elderly are not rare. In most cases with hyperthyroidism, an iodine contamination in subjects with a long-standing goiter seems to have a pathogenetic effect. Hypothyroidism seems to be caused mainly by autoimmune mechanisms. (Aging 3: 325-331, 1991)
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References
Lahey F.H.: Non-activated (apathetic) type of hyperthyroidism. N. Engl. J. Med. 204: 747–748, 1931.
Köbberling J.: Pharmakbtherapie im Alter — Schilddrüsenkrankheiten. Verh. dt. Ges. Inn. Med. 91: 25–31, 1985.
Green M.F.: Endocrine disorders in the elderly. Br. Med. J. I: 232–236, 1974.
Walfish P.G., Gryffe C.I.: Testing your older patient’s thyroid function. Geriatrics 37: 135–150, 1982.
Rönnov-Jessen V., Kirkegaard C: Hyperthyroidism — a disease of old age? Br. Med. J. I: 41–43, 1973.
Tunbridge W.M.G., Evered D.C., Hall R., Appleton D., Brewis M., Clark F., Grimley Evans J., Young E., Bird T., Smith P.A.: The spectrum of thyroid disease in a community: the Whickham survey. Clin. Endocrinol. 7: 481–493, 1977.
Hermann J.: Prevalence of hypothyroidism in the elderly in Germany - a pilot study. J. Endocrinol. Invest. 4: 327–330, 1981.
Nyström E., Petersen K., Lindstedt G., Lundberg P.A.: Screening for thyroid disease in women > 50 years seeking hospital care: influence of common nonthyroidal illness on serum free thyroxin as determined by analog radioimmunoassay. Clin. Chem. 32: 603–608, 1986.
Brochmann H., Björo T., Gaarder P.I., Hanson F., Frey H.M.: Prevalence of thyroid dysfunction in elderly subjects — a randomized study in a Norwegian rural community (Naeroy). Acta Endocrinol. 117: 7–12,1988.
Sawin C.T., Castelli W.P., Hershman J.M., McNamara P., Bacharach P.: The aging thyroid — thyroid deficiency in the Framingham study. Arch. Intern. Med. 145: 1386–1388, 1985.
Riniker M, Tièche M., Lupi G.A., Grob P., Studer H., Bürgi H.: Prevalence of various degrees of hypothy-roidism among patients of a general medical department. Clin. Endocrinol. 14: 69–74, 1981.
Bahemuka M., Hodkinson H.M.: Screening for hypothyroidism in elderly inpatients. Br. Med. J. II: 601–602, 1975.
Szabolcs I., Ploenes Chr., Bernard W., Herrmann J.: Screening of geriatric patients for thyroid dysfunction with thyrotropin-releasing-hormone test, sensitive thyrotropin and free thyroxine estimation. Horm. Metab. Res. 22: 298–302, 1990.
Atkinson R.L., Dahms W.T., Fisher D.A., Nichols A.L.: Occult thyroid disease in an elderly hospitalized population. J. Gerontol. 22: 372–376, 1978.
Hintze G., Windeier J., Baumert J., Stein H., Köbberling J.: Thyroid volume and goiter prevalence in the elderly as determined by ultrasound and their relationship to laboratory indices. Acta Endocrinol 124: 12–18, 1991.
Brunn J., Block U., Ruf G., Bos I., Kunze W.P., Scriba P.C.: Volumetrie der Schilddrüsenlappen mittels Real-time-Sonographie. Dtsch. Med. Wschr. 106: 1338–1340, 1981.
Wawschinek O., Eber O., Petek W., Wakonig P., Gürakar A.: Bestimmung der Harnjodausscheidung mittels einer modifizierten Cer- Arsenitmethode. Ber. ÖGKC 8: 13–15, 1985.
Lloyd W.H., Goldberg I.J.L.: Incidence of hypothyroidism in the elderly. Br. Med. J. II: 1256–1259, 1961.
Sobrinho L.G., Limbert E.S., Santos M.A.: Thyroxine toxicosis in patients with iodine induced thyrotoxicosis. J. Clin. Endocrinol. Metab. 45: 25–29, 1977.
Köbberling J., Hintze G.: Diagnostic problems in iodine induced thyrotoxicosis. In: Köbberling J., Hall R. (Eds.), Thyroid disorders associated with iodine deficiency and excess. Raven Press, New York, 1985, pp. 419–429.
Turner J.G., Brownlie B.E.W., Sadler W.A.: Does T4- toxicosis exist? Lancet I: 407–408, 1975.
Vagenakis A.G., Wang C., Burger A., Maloof F., Braverman L.E., Ingbar S.H.: Iodine induced thyrotoxicosis in Boston. N. Engl. J. Med. 287: 523–527, 1972.
Studer H., Ramelli F.: Simple goiter and its variants: euthyroid and hyperthyroid multinodular goiter. Endocr. Rev. 3: 40–61, 1982.
Bähre M., Hilgers R., Lindemann C., Emrich D.: Thyroid autonomy: sensitive detection in vivo and estimation of its functional relevance using quantified high-resolution scintigraphy. Acta Endocrinol. 117: 145- 153, 1988.
Drinka P.J., Nolten W.E.: Subclinical hypothyroidism in the elderly: to treat or not to treat? Am. J. Med. Sci. 295: 125–128, 1988.
Hoff H.G., Olbricht Th.: Die subklinische Hypothyreose — eine behandlungsbedürftige Erkrankung? Med. Klin. 83: 296–301, 1988.
Althaus B.U., Staub J.J., Ryff-de Lèche A., Oberhänsli A.S., Stähelin H.B.: LDL/HDL-changes in subclinical hypothyroidism: possible risk factors for coronary heart disease. Clin. Endocrinol. 28: 157–163, 1988.
Bell G.M., Todd W.T.A., Forfar J.C., Martyn C., Wathen C.G., Gow S., Riemersma R., Toft A.D.: End-organ responses to thyroxine therapy in subclinical hypothyroidism. Clin. Endocrinol. 22: 83–89,1985.
Bohnet G., Fiedler K., Leidenberger F.A.: Subclinical hypothyroidism and infertility. Lancet II: 1278, 1981.
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Hintze, G., Burghardt, U., Baumert, J. et al. Prevalence of thyroid dysfunction in elderly subjects from the general population in an iodine deficiency area. Aging Clin Exp Res 3, 325–331 (1991). https://doi.org/10.1007/BF03324028
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DOI: https://doi.org/10.1007/BF03324028