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Thyroid Disease Among Senior Citizens

The thyroid, a small, butterfly-shaped gland at the base of the neck that wraps around the trachea, is part of the endocrine system, the body’s hormone-producing system. The thyroid is an important part of the endocrine system that is responsible for setting an individual’s metabolic rate, or how the body converts food to energy. Therefore, thyroid disease means that the body is not using energy at the rate it should, thereby leading to a host of health problems.

The Cleveland Clinic reports that about 20 million Americans have some form of thyroid disease. And, although both men and women can get thyroid disease, it is estimated women are 5 to 8 times more likely to develop thyroid disease than men.

Causes of Thyroid Disease

When the thyroid fails to function properly, or when other systems that regulate the thyroid gland are not functioning properly, a number of conditions can result, including:

  • Hypothyroidism – Hypothyroidism is caused is caused by an underactive thyroid. Hypothyroidism may be caused by a number of factors:
    • Hashimoto’s thyroiditis (autoimmune thyroiditis)
    • Postpartum thyroiditis (inflammation of the thyroid after birth)
    • Silent thyroiditis
    • Thyroid hormone resistance
    • Medications that affect the function of the thyroid
  • Hyperthyroidism – Hyperthyroidism is caused by an overactive thyroid. Hyperthyroidism may be caused by a number of factors:
    • Graves’s disease
    • Toxic multi-nodular goiter
    • Toxic nodule
    • Intake of too much iodine
    • Hashitoxicosis
    • Medications that affect the function of the thyroid

Signs and Symptoms of Thyroid Disease

Signs and symptoms of thyroid disease vary depending on the degree of the thyroid condition. However, common symptoms of hypothyroidism may include:

  • Fatigue
  • Constipation
  • Depression
  • Hair loss
  • Weight gain
  • Low sex drive
  • Muscle aches and stiffness
  • Pale, dry skin
  • Hoarse voice
  • A lack of mental clarity
  • Forgetfulness
  • Fluid retention

Common symptoms of hyperthyroidism include:

  • Increase bowel movements
  • Excessive perspiration
  • Rapid heart rate
  • Slight tremors
  • Weight loss
  • Fatigue
  • Lack of mental clarity/confusion
  • Nervousness
  • Agitation
  • Irregular heart rhythms and heart failure may occur in older patients

However, it is important to understand that hypothyroidism and hyperthyroidism may display a host of symptoms in addition to the ones listed above.

In addition to symptoms caused by an under- or over-acting thyroid, structural problems of the thyroid may also result in thyroid disease, including toxic nodules (adenomas), toxic mutlinodular goiters, and thyroid cancer. Symptoms of structural problems of the thyroid may include:

  • Trouble breathing
  • Trouble swallowing
  • Localized pain
  • If cancer is present, the lymph nodes may be swollen and weight loss and changes in appetite may occur

Diagnosis of Thyroid Disease

There are a number of ways thyroid disease may be diagnosed, but blood tests often serve as an initial screening tool for determining hormone levels and thyroid function. Imaging tests are also commonly used, including thyroid scans, which use a radioactive iodine, and ultrasounds. If non-invasive forms are inconclusive or if tissues samples must be taken to determine cancer, a biopsy is performed.

Treatment for Thyroid Disease

Treatment for thyroid disease may vary, depending on the specific condition being treated.

In the case of hyperthyroidism, a synthetic thyroid hormone (thyroid hormone replacement) may be administered, and steroids, Beta-blockers and anti-inflammatory medications, such as NSAIDs, may be administered to reduce any inflammation when thyroid glands are inflamed.

If the thyroid gland is causing breathing or swallowing difficulties to the patient, if a goiter is causing disfigurement, or if cancer is detected, radioiodine or surgery may be required.  Part the thyroid or the entire thyroid gland may be removed. Upon removal of the thyroid gland, a synthetic thyroid replacement needs to be administered.

Cases of hyperthyroidism that don’t respond to medication are often treated with radioactive ablation. Radioactive ablation is a common treatment for Grave’s disease and thyroid cancer, in particular.

Prevention of Thyroid Disease

Although thyroid disease has a strong genetic component, not smoking, getting adequate exercise, reducing stress, and ensuring a proper intake of dietary iodine (through table salt, seafood, eggs, milk, whole grain breads, and kelp) may all help prevent thyroid disease.

Resources for Thyroid Disease

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