Abstract
Thyrotropin (thyroid-stimulating hormone [TSH]) levels were elevated above 4.0 mU/L (μU/mL) in serum samples from 13.2% of 258 healthy elderly subjects. To investigate the natural history of progressive thyroid failure, serial thyroid functions were measured for four years in 26 of these subjects with elevated TSH levels. In one third of these subjects, biochemical thyroid failure developed (thyroxine level<58 nmol/L [4.5 μg/dL]) within the course of the study. All subjects with initial TSH levels above 20 mU/L (μU/mL), and 80% of those with high-titer thyroid antimicrosomal antibodies (regardless of initial TSH level), became overtly hypothyroid. Compared with subjects with high-titer antibody, those with antibody titer less than 1:1600 had lower TSH and higher thyroxine levels, and thyroid failure developed in none during the study. These results suggest that among older patients with isolated elevations of the TSH level, only those with markedly elevated TSH levels or high-titer antimicrosomal antibodies should be prophylactically treated with levothyroxine sodium replacement.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 209-213 |
| Number of pages | 5 |
| Journal | Journal of the American Medical Association |
| Volume | 258 |
| Issue number | 2 |
| State | Published - 1987 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Medicine(all)
Cite this
Thyroid failure in the elderly. Microsomal antibodies as discriminant for therapy. / Rosenthal, M. J.; Hunt, W. C.; Garry, P. J.; Goodwin, James.
In: Journal of the American Medical Association, Vol. 258, No. 2, 1987, p. 209-213.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Thyroid failure in the elderly. Microsomal antibodies as discriminant for therapy
AU - Rosenthal, M. J.
AU - Hunt, W. C.
AU - Garry, P. J.
AU - Goodwin, James
PY - 1987
Y1 - 1987
N2 - Thyrotropin (thyroid-stimulating hormone [TSH]) levels were elevated above 4.0 mU/L (μU/mL) in serum samples from 13.2% of 258 healthy elderly subjects. To investigate the natural history of progressive thyroid failure, serial thyroid functions were measured for four years in 26 of these subjects with elevated TSH levels. In one third of these subjects, biochemical thyroid failure developed (thyroxine level<58 nmol/L [4.5 μg/dL]) within the course of the study. All subjects with initial TSH levels above 20 mU/L (μU/mL), and 80% of those with high-titer thyroid antimicrosomal antibodies (regardless of initial TSH level), became overtly hypothyroid. Compared with subjects with high-titer antibody, those with antibody titer less than 1:1600 had lower TSH and higher thyroxine levels, and thyroid failure developed in none during the study. These results suggest that among older patients with isolated elevations of the TSH level, only those with markedly elevated TSH levels or high-titer antimicrosomal antibodies should be prophylactically treated with levothyroxine sodium replacement.
AB - Thyrotropin (thyroid-stimulating hormone [TSH]) levels were elevated above 4.0 mU/L (μU/mL) in serum samples from 13.2% of 258 healthy elderly subjects. To investigate the natural history of progressive thyroid failure, serial thyroid functions were measured for four years in 26 of these subjects with elevated TSH levels. In one third of these subjects, biochemical thyroid failure developed (thyroxine level<58 nmol/L [4.5 μg/dL]) within the course of the study. All subjects with initial TSH levels above 20 mU/L (μU/mL), and 80% of those with high-titer thyroid antimicrosomal antibodies (regardless of initial TSH level), became overtly hypothyroid. Compared with subjects with high-titer antibody, those with antibody titer less than 1:1600 had lower TSH and higher thyroxine levels, and thyroid failure developed in none during the study. These results suggest that among older patients with isolated elevations of the TSH level, only those with markedly elevated TSH levels or high-titer antimicrosomal antibodies should be prophylactically treated with levothyroxine sodium replacement.
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M3 - Article
VL - 258
SP - 209
EP - 213
JO - JAMA - Journal of the American Medical Association
JF - JAMA - Journal of the American Medical Association
SN - 0002-9955
IS - 2
ER -