[Health Lecture] An easily overlooked disease - hypothyroidism in the elderly

In order to ensure the popularization effect of learning health knowledge in the 3rd China Elderly Health Knowledge Competition, the organizers have collected various health science articles suitable for the elderly to learn from various hospitals. We will share them through the "Health Lecture Hall" column. Today, Dr. Zhou Hao from Beijing Boai Hospital of China Rehabilitation Research Center brought us "Easily Ignored Diseases-Hypothyroidism in the Elderly", and welcome elderly friends to learn. my country has entered an aging society, and the aging rate is relatively rapid. According to the United Nations forecast, by 2050, China's population aged 65 and above will reach 477 million, accounting for 34.9% of the total population. Paying attention to the physical health of the elderly, popularizing medical and health care knowledge, improving awareness of diseases, and achieving "early detection, early diagnosis and treatment" of diseases is expected to improve the physical health of the elderly in my country and extend life expectancy.

The thyroid gland is a gland located in the front of the neck, which is responsible for secreting thyroid hormones that regulate the body's metabolism. Because of a variety of conditions such as viral infection, autoimmune attack, or brain damage, thyroid dysfunction may occur. Thyroid dysfunction is divided into hyperthyroidism and hypothyroidism. Here, we introduce hypothyroidism in the elderly. Hypothyroidism refers to a syndrome of systemic hypometabolism caused by reduced synthesis and secretion of thyroid hormones or weakened tissue function. As the functions of various organs of the elderly gradually decline, the body is already at a low metabolic level, and the symptoms of hypothyroidism are easily masked, resulting in hypothyroidism in the elderly being easily missed or misdiagnosed. The specific reasons are as follows: 1. Hidden symptoms: The early symptoms of hypothyroidism are often relatively hidden, such as fatigue, decreased physical strength, and mental depression, which are not easy to attract the attention of the elderly. If the symptoms appear in young and middle-aged people, they are likely to attract great attention and will be examined in a timely and comprehensive manner. However, if it occurs in the elderly, it may be mistaken for the manifestation of "normal" aging of the elderly's organ decline and be ignored.

2. Masked by other diseases: Some manifestations of hypothyroidism are similar to the symptoms of other common diseases in the elderly, such as cardiovascular disease and Alzheimer's disease. The elderly may attribute these symptoms to other diseases and fail to seek timely treatment for abnormal thyroid function. 3. Age neglect: Many elderly people believe that abnormal thyroid function mainly occurs in young people and ignore the risk of illness. 4. Lack of medical knowledge: Some elderly people lack understanding of abnormal thyroid function and are unaware of the series of health problems it may cause. Therefore, they are less vigilant about thyroid disease and tend to ignore related symptoms. Because the clinical symptoms of hypothyroidism in the elderly are sometimes inconsistent with the results of thyroid function tests, such patients should be carefully asked about their medical history, carefully undergo physical examinations, and make accurate judgments in a timely manner for various changes in the condition to avoid misdiagnosis.

The following are the main clinical manifestations of hypothyroidism in the elderly.

1. Easy fatigue and physical strength decline. Due to the lack of thyroid hormone in the body, the body's metabolic rate decreases. The elderly may feel tired and lack energy. In severe cases, they may feel that they are unable to do daily activities such as cooking, housework, and walking, and are prone to "weakness". 2. Weight gain. When the thyroid function is reduced, the body's metabolism slows down, the digestive system function declines, and the gastrointestinal motility slows down, which causes the elderly to gain weight. 3. Often afraid of cold and chills. Insufficient secretion of thyroid hormones will reduce the body's heat production, causing the elderly to often feel cold and uncomfortable in the environment. 4. Dry skin and hair loss. Hypothyroidism can affect the skin's moisture balance and hair follicle health, leading to dry skin and hair loss. 5. Constipation and indigestion. Hypothyroidism can lead to slower gastrointestinal motility, causing indigestion such as abdominal distension and constipation in the elderly. 6. Increased cardiac load. Due to the lack of thyroid hormone, the heart's contractility and cardiac output can be reduced, resulting in symptoms of slow heart rate and increased cardiac load in the elderly.

If the elderly experience the above symptoms, they should seek medical attention for relevant examinations in time. They can go to the internal medicine or endocrinology department for outpatient testing to test thyroid hormone levels and related antibodies. It is very important to detect hypothyroidism in the elderly in a timely manner. It can be observed and checked in the following ways: 1. Pay attention to your own symptoms. The elderly should pay attention to changes in their own bodies, such as weight gain, fatigue, frequent coldness, constipation, dry skin, hair loss, etc. If these symptoms occur, they should consult a doctor about thyroid-related issues in time. 2. Pay close attention to family history. If there are cases of thyroid-related diseases in the family, the elderly should pay special attention to whether they have similar symptoms and actively provide family history information to the doctor. 3. Regular physical examinations. The elderly should have regular physical examinations, including measuring thyroid hormone levels. Routine thyroid function tests include TSH (thyroid-stimulating hormone), T4 (thyroxine) and T3 (triiodothyronine). 4. Perform thyroid antibody tests. Autoimmune thyroiditis is one of the common causes of hypothyroidism in the elderly. Detection of anti-thyroid peroxidase antibodies (TPOAb) and anti-thyroglobulin antibodies (TGAb) can help diagnose autoimmune thyroiditis. 5. Trust doctors and work closely with them. Elderly people should not be afraid to see doctors. They should seek medical treatment in a timely manner when they feel unwell. They should maintain a close guidance and cooperation relationship with doctors, inform them of their symptoms and experiences in a timely manner, and cooperate with doctors for relevant examinations and treatments.

For elderly people diagnosed with hypothyroidism, doctors will prescribe corresponding treatment measures according to the specific situation, such as giving patients oral thyroid hormone replacement therapy to promote the recovery of thyroid function and relieve symptoms. Doctors will determine the dosage according to the actual situation of the patient, and regularly monitor thyroid function and adjust the dosage to achieve the ideal treatment effect. At the same time, maintaining a healthy lifestyle is also very important for the treatment of hypothyroidism in the elderly. The elderly should maintain a positive and optimistic attitude, avoid anxiety or depression due to illness, pay attention to a balanced diet, moderate exercise, and maintain proper vitality to maintain a healthy state of body. Pay attention to the elderly around us, carefully perceive the abnormalities of their emotions and physical conditions, and vigorously promote medical and health care knowledge so that this easily overlooked disease-"hypothyroidism in the elderly" can be discovered earlier, and elderly patients can receive formal and systematic treatment as soon as possible to avoid further aggravation of the disease. The elderly should participate in social activities appropriately, actively exchange health knowledge with doctors, friends, etc., enhance health awareness, be healthy elderly people, and enjoy their later years!

About the Author:

Zhou Hao is an associate chief physician at the Department of Critical Care Medicine, Beijing Boai Hospital, China Rehabilitation Research Center. He has been engaged in critical care medicine for more than 30 years and has rich clinical experience. He has unique insights into critical illness with multiple organ dysfunction and early critical illness rehabilitation.