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Editor's Correspondence
January 8, 2001

Screening for Thyroid Dysfunction in the Elderly

Arch Intern Med. 2001;161(1):130. doi:

We read "American Thyroid Association Guidelines for Detection of Thyroid Dysfunction"1 and found the guidelines interesting and informative. We also support the view of the authors that "Physicians must consider and exclude thyroid dysfunction much more often."

In the United Kingdom, screening for thyroid dysfunction is not considered "routine" in elderly hospitalized patients. We measured serum triiodothyronine, thyroxine, and thyrotropin (thyroid-stimulating hormone [TSH]) levels in consecutive elderly (≥65 years) patients at the time of admission to a general hospital in Wales. One hundred ten patients had previous thyroid disease or were taking drugs likely to interfere with the assay results. Among the remaining 280 patients, 9 had newly diagnosed primary hypothyroidism and 5 were newly diagnosed as thyrotoxic—these diagnoses were not suspected clinically before admission. Twenty-one patients had subclinical hypothyroidism (raised TSH levels alone), and 12 patients had subclinical hyperthroidism (low TSH levels alone). Sixty-three patients had sick euthyroid syndrome.

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