Aging & Health A to Z
Causes & Symptoms
Common causes of hypothyroidism in later life include:
- Hashimoto’s disease. This is a disease where your immune system attacks and damages your thyroid gland. The reasons for this aren’t clear. Hashimoto’s disease is the most common cause of hypothyroidism in adults in the United States.
- Side effects of earlier treatment for hyperthyroidism.
- Surgery to remove much or all of the thyroid gland because of disease.
- Radiation treatment for neck or head cancer.
- Certain medications that can reduce thyroid gland functioning
In older adults, hypothyroidism is often asymptomatic (it doesn’t cause noticeable symptoms) early on. If your healthcare provider thinks that you might have hypothyroidism, even though you don’t have noticeable symptoms, he or she can use blood tests to check.
If hypothyroidism isn’t treated, the symptoms get worse and more noticeable. You should contact your healthcare provider as soon as possible if you notice these common symptoms of the disease:
- Low energy levels and slowed thinking
- Weight gain
- Muscle weakness, aches, tenderness, or stiffness
- Pain, stiffness, or swelling in your joints
- Increased sensitivity to cold, or numbness
- Pale, dry skin
- Brittle fingernails and hair
- Swelling in the face
- Erectile dysfunction (difficulty getting an erection)
Hypothyroidism should be treated as soon as possible. If it is untreated, it can lead to other serious health problems such as goiter (enlargement of the thyroid gland). This may eventually make it difficult to swallow or breathe. Untreated hypothyroidism can also increase your risk of heart disease, an enlarged heart, and heart failure. Over time, it can damage your nerves and cause loss of muscle control as well.
Advanced untreated hypothyroidism can lead to a fatal complication known as “myxedema coma.” Warning signs of myxedema coma include: shallow breathing, unresponsiveness, below-normal body temperature, low blood pressure, and low blood-sugar levels. Call 911 for immediate emergency care if you or someone else has these symptoms.
In older adults with mild hypothyroidism, a serious non-thyroid illness may aggravate the hypothyroidism, placing the adult at risk for myxedema coma.
The most common causes of hyperthyroidism in later life include:
- Graves' disease. This is an autoimmune disorder where your own antibodies attack the thyroid gland, which causes it to produce too much thyroid hormone. This is the most common cause of hyperthyroidism in older adults in the United States.
- Cancerous or non-cancerous thyroid gland tumors.
- Cancerous or non-cancerous pituitary gland tumors.
- Other disorders that cause enlargement of the thyroid gland.
Symptoms of hyperthyroidism are often different in later adulthood than in earlier adulthood. In younger adults, hyperthyroidism typically causes such symptoms as hyperactivity and weight loss. The following symptoms are most common among older adults with hyperthyroidism:
- Abnormal heart rhythms (such as atrial fibrillation or a rapid heartbeat)
- Heart failure
- Muscle weakness and loss of muscle
- Difficulty tolerating heat and increased sweating
- Frequent bowel movements
- Graves’ ophthalmopathy, a symptom of Grave’s disease in which the eyes begin to bulge outward. Graves’ ophthalmopathy is more common among older than younger adults with hyperthyroidism
- Erectile dysfunction
Thyroid disorders can also cause psychiatric symptoms, including mania, panic attacks, and anxiety.
Older adults with the form of hyperthyroidism known as apathetic thyrotoxicosis often have the following symptoms:
- Bone loss
- Inactivity and lack of energy
- Muscle weakness
Thyroid nodules may be caused by:
- Ongoing or chronic inflammation of your thyroid gland due to Hashimoto's disease.
- Insufficient iodine in your diet. However, this is rare in the US, where iodized salt is added to many prepared foods.
Many thyroid nodules cause no obvious symptoms and most people don’t realize they have a nodule until their healthcare provider detects it during a routine check-up. Approximately 90% of women over 70 years old, and 60% of men over 80 years old, have thyroid nodules. Most of these nodules are not palpable (which means that your healthcare provider cannot feel them). These nodules are often detected incidentally on imaging studies done for other reasons. Sometimes, though, a nodule can get big enough to be noticeable. Thyroid nodules may eventually get large enough for you to see, or they may press on your throat so it is uncomfortable or difficult to breathe or swallow.
Some nodules increase the amount of triiodothyronine hormone (T3) that your thyroid produces, causing symptoms of hyperthyroidism. A small percentage of thyroid nodules become cancerous.
Thyroid Cancer Risks
You have a higher than average risk of developing thyroid cancer if you:
- Are older than 60
- Have had radiation treatment in the past, especially to the head or neck
- Have a family history of thyroid or other cancers affecting the body’s glands
- Have been exposed to radiation due to an accident
- Are male
Updated: June 2017
Posted: March 2012