0
May 12, 1989, Vol 261, No. 18 >
ARTICLE | May 12, 1989

The Aging Thyroid: Title and subTitle BreakThe Use of Thyroid Hormone in Older Persons FREE

Clark T. Sawin, MD; Andrew Geller, MD; Jerome M. Hershman, MD; William Castelli, MD; Pamela Bacharach
[+] Author Affiliations

Reprint requests to Veterans Administration Medical Center, 150 S Huntington Ave, Boston, MA 02130 (Dr Sawin).


JAMA. 1989;261(18):2653-2655. doi:10.1001/jama.1989.03420180077034
Text Size: A A A
Published online
Article
References

The overall prevalence of thyroid hormone use in an unselected population of older adults (n = 2575; average age, 68.6 years) was 6.9% (10.0% in women and 2.3% in men). Eighty-one percent of women taking it were doing so for appropriate indications, eg, hypothyroidism, while 12% were not, eg, for obesity or high serum cholesterol; more men (29%) were taking it inappropriately. Inappropriate use was associated with desiccated thyroid more than with thyroxine. After follow-up averaging 6.9 years, 58% of inappropriate users were still taking it. Underuse also occurred. Thirty-seven percent of those definitely hypothyroid had a clearly elevated serum thyrotropin level (>10 mU/L) despite thyroid therapy. Thyroid therapy is common in the elderly; most is appropriate. When inappropriate use occurs, it is more common in men and more often associated with desiccated thyroid, still commonly used in this age group. In chronic users of thyroid hormone, it is important to review currently appropriate indications and to measure serum thyrotropin levels to assess the adequacy of treatment of primary hypothyroidism.

(JAMA. 1989;261:2653-2655)

REFERENCES

1 +
Murray GR.  Note on the treatment of Myxoedema by hypodermic injections of an extract of the thyroid gland of a sheep . Br Med J. 1891;;2:796.
2 +
Harrower HR. Practical Hormone Therapy . London, England: Bailliere Tindall & Cox; 1914;:180.
3 +
Lyon DM.  Thyroid extract in conditions other than myxoedema . In: The Endocrines in Theory and Practice . Philadelphia, Pa: Blakiston; 1937;: 123-128.
4 +
Means JH. The Thyroid and Its Diseases . 2nd ed. Philadelphia, Pa: JB Lippincott; 1948;:534-550.
5 +
Leaverton PE, Sorlie PD, Kleinman JC, et al.  Representativeness of the Framingham risk model for coronary heart disease mortality: a comparison with a national cohort study . J Chronic Dis. 1987;;40:775-784.
6 +
Chopra IJ.  A radioimmunoassay for measurement of thyroxine in unextracted serum . J Clin Endocrinol Metab. 1972;;34:938-947.
7 +
Pekary AE, Hershman JM, Parlow AF.  A sensitive and precise radioimmunoassay for human thyroid-stimulating hormone . J Clin Endocrinol Metab. 1975;;41:676-684.
8 +
Sawin CT, Castelli WP, Hershman JM, McNamara P, Bacharach P.  The aging thyroid: thyroid deficiency in the Framingham Study . Arch Intern Med. 1985;;145:1386-1388.
9 +
Kapdi CC, Wolfe JN.  Breast cancer: relationship to thyroid supplements for hypothyroidism . JAMA . 1976;;236:1124-1127.
10 +
Shapiro S, Slone D, Kaufman DW, et al.  Use of thyroid supplements in relation to the risk of breast cancer . JAMA . 1980;;244:1685-1687.
11 +
Rendell M, Lassek WD, Ross DA, et al.  A pharmaceutical profile of diabetic patients . J Chronic Dis. 1983;;36:193-202.
12 +
Royce PC, MacKay BR, DiSabella PM.  Value of postirradiation screening for thyroid nodules . JAMA . 1979;;242:2675-2678.
13 +
DeGroot LJ, Larsen PR, Refetoff S, Stanbury JB, eds. The Thyroid and Its Diseases . New York, NY: John Wiley & Sons Inc; 1984;:832-850.
14 +
Wilson IC, Prange AJ, McClane TK, Rabon AM, Lipton MA.  Thyroid-hormone enhancement of imipramine in nonretarded depressions . N Engl J Med. 1970;; 282:1063-1067.
15 +
Krugman LG, Hershman JM, Chopra IJ, et al.  Patterns of recovery of the hypothalamic-pituitary-thyroid axis in patients taken off chronic thyroid therapy . JClin Endocrinol Metab. 1975;;41:70-80.
16 +
Rizzolo PJ, Fischer PM.  Re-evaluation of thyroid hormone status after long-term hormone therapy . J Fam Pract. 1982;;14:1017-1021.
17 +
Jones A, Corbett DG, Davies JB, et al.  Evaluation of long term thyroid replacement treatment . Br Med J. 1985;;291:1476-1478.
18 +
Molitch ME, Spare SV, Arnold GL, Fawaz K, Scally J, Zack N.  Pituitary-thyroid function after cessation of prolonged thyroid suppression . N Engl J Med. 1976;;295:231.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Murray GR.  Note on the treatment of Myxoedema by hypodermic injections of an extract of the thyroid gland of a sheep . Br Med J. 1891;;2:796.
2 +
Harrower HR. Practical Hormone Therapy . London, England: Bailliere Tindall & Cox; 1914;:180.
3 +
Lyon DM.  Thyroid extract in conditions other than myxoedema . In: The Endocrines in Theory and Practice . Philadelphia, Pa: Blakiston; 1937;: 123-128.
4 +
Means JH. The Thyroid and Its Diseases . 2nd ed. Philadelphia, Pa: JB Lippincott; 1948;:534-550.
5 +
Leaverton PE, Sorlie PD, Kleinman JC, et al.  Representativeness of the Framingham risk model for coronary heart disease mortality: a comparison with a national cohort study . J Chronic Dis. 1987;;40:775-784.
6 +
Chopra IJ.  A radioimmunoassay for measurement of thyroxine in unextracted serum . J Clin Endocrinol Metab. 1972;;34:938-947.
7 +
Pekary AE, Hershman JM, Parlow AF.  A sensitive and precise radioimmunoassay for human thyroid-stimulating hormone . J Clin Endocrinol Metab. 1975;;41:676-684.
8 +
Sawin CT, Castelli WP, Hershman JM, McNamara P, Bacharach P.  The aging thyroid: thyroid deficiency in the Framingham Study . Arch Intern Med. 1985;;145:1386-1388.
9 +
Kapdi CC, Wolfe JN.  Breast cancer: relationship to thyroid supplements for hypothyroidism . JAMA . 1976;;236:1124-1127.
10 +
Shapiro S, Slone D, Kaufman DW, et al.  Use of thyroid supplements in relation to the risk of breast cancer . JAMA . 1980;;244:1685-1687.
11 +
Rendell M, Lassek WD, Ross DA, et al.  A pharmaceutical profile of diabetic patients . J Chronic Dis. 1983;;36:193-202.
12 +
Royce PC, MacKay BR, DiSabella PM.  Value of postirradiation screening for thyroid nodules . JAMA . 1979;;242:2675-2678.
13 +
DeGroot LJ, Larsen PR, Refetoff S, Stanbury JB, eds. The Thyroid and Its Diseases . New York, NY: John Wiley & Sons Inc; 1984;:832-850.
14 +
Wilson IC, Prange AJ, McClane TK, Rabon AM, Lipton MA.  Thyroid-hormone enhancement of imipramine in nonretarded depressions . N Engl J Med. 1970;; 282:1063-1067.
15 +
Krugman LG, Hershman JM, Chopra IJ, et al.  Patterns of recovery of the hypothalamic-pituitary-thyroid axis in patients taken off chronic thyroid therapy . JClin Endocrinol Metab. 1975;;41:70-80.
16 +
Rizzolo PJ, Fischer PM.  Re-evaluation of thyroid hormone status after long-term hormone therapy . J Fam Pract. 1982;;14:1017-1021.
17 +
Jones A, Corbett DG, Davies JB, et al.  Evaluation of long term thyroid replacement treatment . Br Med J. 1985;;291:1476-1478.
18 +
Molitch ME, Spare SV, Arnold GL, Fawaz K, Scally J, Zack N.  Pituitary-thyroid function after cessation of prolonged thyroid suppression . N Engl J Med. 1976;;295:231.

Letters

Submit a Letter
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2012 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems