Thyroid Problems

Basic Facts

As people age their thyroid levels can change. They also have a higher risk of having other changes to their thyroids.  These changes make diagnosis and treatment tricky. Women have a higher risk than men.

Age-Related Changes

Thyroid hormone levels change with age.  Any testing needs to take these age-related changes into account.

Sometimes older adults whose thyroid hormone levels decrease don’t need treatment.

  • An older adult’s thyroid-stimulating hormone level may increase and then stabilize. Treatment may not be necessary in this case.
  • An older adult may have hypothyroidism with few symptoms. In this case, treatment with additional thyroid hormone generally doesn’t improve health, symptoms, quality of life, or cognition (thinking and memory).
  • As people age, their thyroid nodules (lumps) are less likely to be cancer and often don’t need treatment. However, if they are cancerous, the cancer is often aggressive.
  • Older adults may take medications that affect their thyroids and hormone levels can vary over time. Changes in medications can solve the problem.
  • Being in the hospital can also affect a person’s hormone levels. So, thyroid hormone levels sometimes need testing over time to make a definite diagnosis.

Common Thyroid Problems

Hypothyroidism (Underactive Thyroid)

Hypothyroidism means the thyroid doesn’t make enough thyroid hormone, usually thyroxine (T4). This can happen because of an illness, such as infection. In that case, the thyroid can go back to normal after the person gets better.

However, with hypothyroidism, T4 levels remain low. Usually, the brain reacts by trying to stimulate the thyroid to make more T4. A gland in the brain does this by producing a hormone knows as thyroid-stimulating hormone (TSH). Most people who have hypothyroidism will have low blood levels of T4 and high blood levels of TSH. Symptoms of hypothyroidism include fatigue, weight gain, depression and constipation.

Hyperthyroidism (Overactive Thyroid)

Hyperthyroidism happens when the thyroid gland makes too much thyroid hormone. This disease can cause many symptoms such as increased sweating and irregular heartbeat and loss of bone mineral density.

People who take thyroid hormone may get too much of it and end up having hyperthyroidism.

Older adults may also have a form of hyperthyroidism known as apathetic thyrotoxicosis, which causes many symptoms similar to hypothyroidism.

Thyroid Nodules 

Thyroid nodules are solid or fluid-filled lumps in the thyroid gland. 

Thyroid Cancer 

Most thyroid nodules aren’t cancer, but about 10 percent of them can turn out to be cancerous.

How Common are Thyroid Problems?

Hypothyroidism (underactive thyroid) is common among adults age 60 and over.

  • Up to 15 percent of adults age 70 and older have this condition with few if any symptoms and may not need treatment. There is not a higher risk of heart disease or death when a person has few symptoms.
  • Up to 25 percent of nursing home residents have hypothyroidism.

Hyperthyroidism (overactive thyroid) also happens to adults age 60 and over:

  • Up to 10 percent of older adults have hyperthyroidism with symptoms.
  • 25 percent of cases of thyrotoxicosis (too much thyroid hormone in the blood) happen to older adults, generally as a result of Graves disease (an immune system disease that causes too much thyroid hormone).

Thyroid nodules (lumps)

  • At least half of older adults have thyroid nodules.
  • 90 percent of women over 70 years old have nodules.
  • 60 percent of men over 80 years old have thyroid nodules.

 

Last Updated December 2022