Thyroid Disorders in Older Adults

Thyroid disorders are common in older adults and may range from subclinical disease to overt thyroid under-activity or over-activity. Subclinical disease is common and requires regular follow-up and an evidence-based approach to guide subsequent management, since clinical consequences may be significant. Practitioners should be diligent about ascertaining the specific diagnosis in frail older adults on thyroid supplementation or suppression treatment. Abnormal thyroid function tests should be interpreted in the context of the clinical scenario as well as current medication regimen. A high index of suspicion should be maintained for the presence of secondary thyroid disease due to pituitary dysfunction. The finding of nodular thyroid disease requires systematic measurement of thyroid function and appropriate imaging studies and biopsy if indicated and consistent with the patient’s care goals.