Thyroid disorders often missed in seniors

DEAR SAVVY SENIOR: Can you write a column on the overlooked problem of thyroid disease? After struggling with chronic fatigue, joint pain and memory problems, I was finally diagnosed hypothyroidism. Now, at age 70, I’m on thyroid medication and am doing great. Five years of feeling lousy. I wish I’d have known. — Frustrated Patient

DEAR FRUSTRATED: I’m glad to hear that you’re finally feeling better. Unfortunately, thyroid problems are quite common in older adults but can be tricky to detect because the symptoms often resemble other agerelated health problems. In fact, as many as 30 million Americans have some form of thyroid disorder, but more than half of them aren’t aware of it.

Here’s a basic overview: The thyroid is a small butterfly-shaped gland located at the base of your neck that has a huge job. It produces hormones (called T3 and T4) that help regulate the rate of many of your body’s activities, from how quickly you burn calories to how fast your heart beats. It also influences the function of the brain, liver, kidneys and skin.

If the gland is underactive and doesn’t produce enough thyroid hormones, it causes body systems to slow down. If it’s overactive, and churns out too much thyroid, it has the opposite effect, speeding up the body’s processes.

The symptoms for an underactive thyroid (also known as hypothyroidism) — the most common thyroid disorder in older adults — will vary but may include fatigue, unexplained weight gain, increased sensitivity to cold, constipation, joint pain, muscle stiffness, dry skin and depression. Some patients may even develop an enlarged thyroid (goiter) at the base of the neck. However, in older adults, it can cause other symptoms such as memory impairment, loss of appetite, weight loss, falls or even incontinence.

And the symptoms of an overactive thyroid (or hyperthyroidism), which is more common in people under age 50, may include a rapid heart rate, anxiety, insomnia, increased appetite, weight loss, diarrhea, excessive perspiration, as well as an enlarged thyroid gland. Too much thyroid can also cause atrial fibrillation, affect blood pressure and decrease bone density, which increases the risk of osteoporosis.

Those with the greatest risk of developing thyroid disorders are women who have a family history of the disease. Other factors that can trigger thyroid problems include: autoimmune diseases such as Hashimoto’s or Graves disease; thyroid surgery; radiation treatments to the neck or upper chest; and certain medications including interferon alpha and interleukin-2 cancer medications, amiodarone heart medication and lithium for bipolar disorder.

GET TESTED

If you have any of the aforementioned symptoms, or if you’ve had previous thyroid problems or notice a lump in the base of your neck, ask your doctor to check your thyroid levels. The TSH (thyroidstimulating hormone) blood test is used to diagnosis thyroid disorders.

Thyroid disease is easily treated once you’ve been diagnosed. Standard treatment for hypothyroidism involves daily use of the synthetic thyroid hormone levothyroxine (Levothroid, Synthroid and others), which is an oral medication that restores adequate hormone levels.

And treatments for hyperthyroidism may include an anti-thyroid medication such as methimazole (Tapazole), which blocks the production of thyroid hormones. Another option is radioactive iodine, which is taken orally and destroys the overactive thyroid cells and causes the gland to shrink. But this can leave the thyroid unable to produce any hormone and it’s likely that you’ll eventually become hypothyroid and need to start taking thyroid medication.