Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Thyroid Function in Older Adults Evaluated

Thyroid; ePub 2017 Oct 13; Mammen, McGready, et al

Changing thyroid hormone function appears to be more common as patients age and has a negative impact on survival, according to a study involving 640 individuals. Participants were from the Baltimore Longitudinal Study of Aging, were not taking medications, and had at least 3 serum thyroid stimulating hormone (TSH) and free thyroxine (fT4) measures available. Among the results:

  • Most patients had stable thyroid function.
  • Changes were more common in older adults, occurring in one-third of those aged >80 years, but in only 10% in those <60.  
  • Patients in either the upper or lower quintiles of thyroid function change were >5 times likely to die than those with stable thyroid status.

The authors noted that clinicians should 1) not automatically assume that elevated TSH levels represent subclinical hypothyroidism in older adults, and 2) proceed cautiously when determining the need for thyroid hormone supplements.


Mammen J, McGready J, Ladenson P, Simonsick E. Unstable thyroid function in older adults is caused by alterations in both thyroid and pituitary physiology and is associated with increased mortality. [Published online ahead of print October 13, 2017]. Thyroid. doi:10.1089/thy.2017.0211.

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