Endocrine Abstracts

Introduction: Hypothyroidism affects 2 to 3% of the elderly population. Its diagnosis and management can get difficult considering the clinical and biological particularities of this age range. The aim of this study is to describe the clinical characteristics, diagnosis and management data of elderly patients suffering from hypothyroidism.

Materials and methods: This is a retrospective and descriptive study conducted in the Endocrinology-Diabetology-Nutrition Department of Mohammed VI University Hospital, Oujda, Morocco. It included 22 patients aged over 65 years with hypothyroidism.

Results: The mean age was 71.73±8.72 years with extreme ages (65 years and 91 years). A female predominance was observed. Hypothyroidism was incidentally discovered on biological assessment in 54% of the cases. 31.8% of the patients showed signs of hypometabolism. The major comorbidities associated to hypothyroidism were: Hypertension (69%), diabetes mellitus type 2 (61%), heart diseases (30%) and dyslipidemia (15%). The diagnosis was confirmed in all patients using TSH and FT4 blood tests. 16% of the patients had a subclinical hypothyroidism profile. Primary hypothyroidism was found in 53% of the cases including: autoimmune thyroiditis (49%), previous thyroid surgery (16%) and Amiodarone therapy (8.3%). The etiology was unknown in 16% of the cases. 31% of the patients had a central hypothyroidism due to pituitary adenoma in most of the cases. A thyroid hormone replacement therapy with L-thyroxin was prescribed for all patients. The majority of patients needed a small initial dose, which was increased progressively with close monitoring.

Conclusion: Hypothyroidism is the most common thyroid condition in patients over 65 years, occurring most frequently in aging women. Hypothyroidism associated symptoms are very similar to those of the aging process. Thus, the screening, by measuring thyroid-stimulating hormone (TSH) blood levels, for older patients is recommended. Caution is advised when treating elderly patients with synthetic thyroid hormone, while taking into consideration the coexisting comorbidities.