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Elderly May be More Likely to Die If They
Have Subclinical Hyperthyroidism
Newswise, June 6, 2011 — A common hormone
abnormality in older adults—a mild form of
overactive thyroid called subclinical
hyperthyroidism—is linked to a much higher
risk of dying, a new study finds.
The results will be presented Sunday at The
Endocrine Society’s 93rd Annual Meeting in
Boston.
Because this condition sometimes does not
even cause symptoms, elderly people may be
unaware they have altered thyroid function
until serious complications occur, said the
study’s main author, Graziano Ceresini, MD,
PhD, a clinical researcher at the University
of Parma in Italy.
“Subclinical hyperthyroidism can be
responsible for important medical problems,
such as cardiac arrhythmias—irregular
heartbeat—as well as altered bone structure
and cognitive abnormalities, especially in
elderly individuals,” Ceresini said.
“Now we know that it also may be accompanied
by increased mortality in people ages 65 and
older.”
In the new study, the investigators used
data from the Italian Aging in the Chianti
Area study to evaluate the relationship
between thyroid function and death from all
causes in older people.
Thyroid function test results were available
for 950 subjects age 65 or older. At
enrollment in the study, 819 subjects (86
percent) had normal thyroid function and 83
(nearly 9 percent) had subclinical
hyperthyroidism.
Technically, subclinical hyperthyroidism is
a below-normal or undetectable blood
concentration of thyroid-stimulating hormone
(TSH) with normal levels of the thyroid
hormones called free T3 and T4.
In evaluating the death statistics, the
researchers adjusted for age, sex and other
factors that could bias the results, such as
congestive heart failure, body mass index,
cancer and stroke. They found that subjects
who had subclinical hyperthyroidism at the
beginning of the study had a 65 percent
higher risk of dying during the six-year
follow-up than did subjects with normal
thyroid function.
“Although our results would suggest the need
for thyroid function testing in elderly
people, confirmation of our data by further
studies is needed before a screening
recommendation can be made. There are no
current recommendations to test all elderly
individuals for subclinical
hyperthyroidism,” Ceresini said.
He suggested, however, that elderly persons
with signs of subclinical hyperthyroidism,
especially arrhythmias or thyroid disease,
should ask their doctor about getting a
thyroid function test. Other symptoms may
include weight loss, feeling too hot and
nervousness.
Subclinical hypothyroidism, or a mildly
underactive thyroid, also is common in
elderly people but in this study was not
linked to decreased survival. There were not
enough subjects with overt underactive or
overactive thyroid to analyze their death
risk, the authors reported.
The National Institute on Aging participated
in and helped fund this study. Both the
Italian Ministry of Health and the Italian
Ministry of University and Research also
provided funding.
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