Thyroid disorders in the elderly

As the population ages and the number of people reaching old age increases, awareness of illnesses common in elderly individuals and their unique features in the aged assumes greater importance. Disorders of the thyroid are common in the elderly, and can have unusual manifestations. Familiarity with prevalence, diagnosis, and management of thyroid disorders in the aged is of utmost importance, as inappropriate diagnosis or mismanagement can lead to grave consequences. Overt hypothyroidism is treated with levothyroxine; subclinical hypothyroidism has not been convincingly associated with adverse outcomes and before elderly patients are labeled with this condition, the higher upper limit of TSH in this age range should be considered as an alternate explanation. Hyperthyroidism can have subtle manifestations in the elderly; subclinical hyperthyroidism can lead to adverse cardiovascular and skeletal outcomes.