Thyroid Disorders & Treatments Aging & the Thyroid

Thyroid Problems Over 50

As we age, the thyroid gland often functions less well, particularly in producing less thyroid hormone than we need. And because it just seems like "we are getting older" thyroid testing is often overlooked. In addition, some of us may not get the right thyroid treatment, which can help.

DON'T let your doctor skip your TSH test (for thyroid stimulating hormone) at least once every five years if you are over 50 or more often if you have symptoms.

By age 50, 10% of women have signs of thyroid failure (TSH is high).
By age 60, 17% of women and 8% of men have a high TSH (thyroid function will be below normal).

Testing is particularly important if you have these signs
indicating possible hypothyroidism (too little hormone):

fatigue
chilliness
constipation
forgetfulness
muscle cramps
hair loss
depression

—or these signs indicating possible hyperthyroidism (too much hormone)

weight loss (not always present in the elderly)
hyperactivity
weakness
palpitations
tremor
nervousness
insomnia

Obviously all these problems can have a dozen causes-only the correct blood tests will make sure.

DON'T decide you "just can't cope" unless you know for sure it's not an easily treatable thyroid problem that's making things so difficult for you.

Thyroid Treatment

Treatment to balance your hormone levels is simple and not very expensive. Initiation of treatment, however, should be done gradually, because older hearts may overreact to the changes and the treatment could cause irregular heart beats or even chest pains.

If you make too little thyroid hormone, you can take the missing thyroxine in pill form, often beginning with a very small dose of 0.025 mg (25 micrograms) or 0.05 mg (50 micrograms) and going up gradually guided by your thyroid tests, done usually at six to eight week intervals. Your doctor may find that you need very little thyroid hormone to normalize your blood tests. Try to insist that your doctor prescribes brand name thyroid hormone whenever possible. Not that generics are bad, it’s just that they sometimes vary from manufacturer to manufacturer, which would require extra office visits and blood testing each time you get a new refill. Also, shop around for your medication. Sometimes, an HMO will allow only 30 days of medication to be dispensed. Your co-payment required may be more than it would cost you to buy the pills yourself, as well as costing you the inconvenience of going to the pharmacy once a month. Just take an extra minute to price things when you are at your pharmacy next time.

If you make too much hormone, there are drugs to control your symptoms and make the gland stop over-producing. Often, however, these medications only are a temporary measure and the hyperthyroid state may return once the pills are stopped. Therefore, many doctors will opt for definitive treatment right away. The overproducing cells can be disabled by radioactive iodine, almost always given just one time in your doctor’s office or in a radiology center. Then, if necessary, you can receive thyroid hormone in pill form. Your doctor will continue to follow you also to make sure the dose of thyroid hormone is correct.

Screening

You must be tested properly if:

You had a goiter or other thyroid problem when younger.
You had childhood neck irradiation for conditions such as acne, tonsillitis, or a big thymus gland.
Your family has thyroid problems or other autoimmune problems like rheumatoid arthritis, Type I diabetes, and pernicious anemia or a skin condition called vitiligo.
You have lumpiness or soreness in the thyroid gland at the lower front of the neck.
You have had extra radiation such as exposure to nuclear fallout, or X-ray treatments on or near the neck for a medical condition like Hodgkin's Disease.

Cancer

Thyroid cancer is rare. Fortunately, these tumors are often easier to treat successfully than other kinds of cancer. However, you don't want to get careless about it.

Thyroid cancer almost always presents with a lump in your neck area. If your doctor feels a lump or nodule in your gland, or if an ultrasound, CAT scan or MRI scan shows you have one or more lumps, you may need further tests, perhaps including a biopsy, to rule out cancer. And even if tests indicate a harmless nodule, your doctor will likely recheck your thyroid every few months until it is clear that the nodules aren’t growing larger, harder, or changing in other ways that might suggest they contain cancer after all. If you already have this problem or your doctor discovers a lump in your neck, you might ask to be referred to an endocrinologist for the most effective evaluation and treatment.