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Hypothyroidism (Underactive Thyroid) in Seniors

An age-related decrease in the metabolism is considered to be a “normal” part of aging. While there is a slight dip in energy levels in the senior years, it should not be at a point where the metabolic rate drops drastically. Such a change in metabolism is due to a condition known as hypothyroidism, where the thyroid gland becomes underactive. It is a treatable condition and it is important that the elderly do not assume such underactivity of the thyroid gland is a normal part of the aging process.

What is hypothyroidism?

Hypothyroidism, also referred to as an underactive thyroid, is a state where the thyroid gland fails to produce sufficient thyroid hormones. Thyroxine (T4) and triiodothyronine (T3) are the two hormones produced by the thyroid gland. These hormones play important roles in controlling body temperature and regulating the metabolism of carbohydrates and fats as well as the production of various proteins. When the levels of thyroid hormone are lowered, the rate of metabolism is decreased. This increases the risk of various health problems such as joint pain, obesity and cardiac diseases.

What are the symptoms of hypothyroidism?

Women are more affected by hypothyroidism than men, especially with advancing age. The symptoms develop gradually and vary depending on the level of hormonal deficiency. The early symptoms of hypothyroidism are :

  • chronic fatigue
  • sluggishness
  • muscle and joint aches
  • sensitivity to cold
  • weight gain
  • constipation
  • menstrual irregularities

With time, other symptoms also appear such as impaired mental activity, depression, muscle weakness, hearing loss, husky voice, numbness, pain and cramps.

Myxedema, a very rare but life-threatening disease is advanced stage of hypothyroidism. The major signs and symptoms of myxedema are a drop in blood pressure and body temperature, slowing down of respiration, unresponsiveness and occasionally coma.

What causes hypothyroidism?

Other than underproduction of thyroid hormones, several other factors are responsible for hypothyroidism such as :

  • Autoimmune disease: In Hashimoto’s thyroiditis, the body’s immune system produces antibodies against its own thyroid gland. This results in thyroid enlargement or goiter, which progresses to gradual thyroid destruction.
  • Drugs: Some prescription medications like lithium and amiodarone also alter thyroid function.
  • Thyroid treatment: In people suffering from hyperthyroidism, generally radioactive iodine or anti-thyroid medications are given to normalize the thyroid imbalance. However, sometimes these treatments may lead to permanent hypothyroidism.
  • Pituitary and hypothalmic dysfunction: As hypothalamus and pituitary gland regulate the functions of the thyroid gland, diseases affecting them can results in the lesser production and secretion of thyroid hormones. Hypothyroidism arising due to disease of pituitary gland is known as “secondary hypothyroidism. Similarly, hypothyroidism that occurs due to disease of hypothalamus is known as “tertiary hypothyroidism.”
  • Pregnancy and iodine deficiency also play major roles in hypothyroidism.

Although anyone can develop hypothyroidism, risk factors of hypothyroidism include women who are above 50 years of age. People having an autoimmune disease or having close relative with an autoimmune disease are also at greater risk for developing hypothyroidism. Treatments with anti-thyroid drugs, radioactive iodine, history of thyroid surgery and radiation exposure to neck or upper part of chest are also risk factors.

How is hypothyroidism treated?

For the treatment of hypothyroidism, synthetic thyroid hormone (levothyroxine) is given daily. Determining proper dosage of levothyroxine may take time. Generally the level of thyroid stimulating hormone (TSH) is checked after two to three months to determine the proper dose. The intake of excessive amounts of the hormone can cause side effects, such as insomnia, increased appetite and heart palpitations.


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