The Aging Thyroid
Increased Prevalence of Elevated Serum Thyrotropin Levels in the Elderly
Clark T. Sawin, MD;
Deepak Chopra, MD; Fereidoun Azizi, MD; Jo Ellen Mannix; Pamela Bacharach
Of 344 relatively healthy persons older than 60 years, 22 (5.9%) had a clearly elevated level of serum thyrotropin (TSH) (>10 \g=m\U/mL), a finding
more common
Most were recruited from several Senior Citizens' Centers in metropolitan Boston;
some were
in women than in
men.
Ten of the 22 had low values for
serum
attending
an
thyroxine (T4) and free T4 (FT4) index, but only one had a low value for serum triiodothyronine (T3) or free T3 (FT3) index. A further 14.4% had a slightly elevated level of serum TSH (>5\m=le\10\g=m\U/mL), but none had low values for serum T4 or FT4 index. Age alone has little effect on the measurements of T4; age is associated with slightly lower T3 levels, but only in men 60 years or older or in women 80 years or older. Longitudinal studies should determine if a slightly elevated serum TSH rises further with age and if there is a causal relationship between a high level of serum TSH and cardiovascular disease. (JAMA 242:247-250, 1979)
and symptoms of hypothyroidism are often atypical in older persons1 and are insensitive measures of mild
deficiency in the elderly, particularly if of mild degree, may not be recognized because the signs
THYROID
See also pp 251,
254,
and 275.
hypothyroidism
more,
serum
a
at any age.2 Further decrease in the levels of
or
roxine (T4) may be due to aging itself34 or concomitant chronic ill ness,56 and mild hypothyroidism may still be associated with serum levels
From the Medical Services, Boston Veterans Administration Hospital (Drs Sawin and Chopra, Ms Bacharach), St Elizabeth's Hospital (Dr Azizi, Ms Mannix), and the Department of Medicine, Tufts University School of Medicine, Boston. Reprint requests to Boston Veterans Administration Hospital, 150 S Huntington Ave, Boston, MA 02130

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