Diseases of the thyroid gland with a focus on senior age.

Česká verzia

Authors: Z. Límanová
Published in the journal: Geriatrie a Gerontologie 2016, 5, č. 1: 28-33
Category: Review Article

Summary

Incidence of thyroid gland functional disorders is higher in women than in men (min. 8: 1), whereas hyperfunction is usually connected with bothersome symptoms, reduced function often remains unnoticed. According to recent epidemiological studies the undiagnosed dysfunctions have a prevalence that reaches 6–7 %. Goitre used to be mainly a consequence of iodine deficiency. In the Czech Republic the iodine deficiency was solved in the 1950’s, so we only find goitre in the older population. Thyroid hyperfunction in senior population is usually a result of nodular goitre or toxic independent adenoma rather than from Grave´s disease. Treatment of such conditions is necessary, negative impacts on heart and bones are known, good experiences with radioiodine treatment predestine this method for application mainly in older population. Patients with hypothyroidisms must be treated and the method is the same as for young people, but it is important to start with minimal dose of levothyroxine and increase slowly. For very old seniors collaboration with the family necessary is sometimes necessary, mainly to control the exact dosing and application of the medication as well. The incidence of thyroid carcinoma is rising, surgeries are possible also for seniors, but always by specialized team of surgeons.

KEYWORDS:
goiter – hypothyroidism – hyperthyroidism – age – senior

Zdroje

1. Klener P, a kol. Vnitřní lékařství, 2011. Praha: Galén. 939–953.

2. Zamrazil V. Kontroverzní otázky diagnostiky a léčby tyreopatií. Lékařské listy 2005; 49(9): 12: 7–9.

3. Jiskra J. Management of hypothyroidism and hyperthyroidism. Vnitr Lek 2015; 61(10): 868–871.

4. Garmendia MA, Santos-Palacios S, et al. The incidence and prevalence of thyroid dysfunction in Europe: a metaanalysis. J Clin Endocrinol Metab 2014; 99(3): 923–931.

5. Límanová Z. Šedá eminence v medicině – štítná žláza. Čas Lek Čes 2009; 148: 124–128.

6. Vondra K, Zamrazil V. Autoimmune polyendocrine syndrome. Vnitr Lek 2010; 56(11): 1111–1113.

7. Barbesino G. Drugs affecting thyroid function. Thyroid 2010; 20: 763–770

8. Tajtáková M: Lieky a štitna žlaza. Vnitř Lék 2012; 58(2): 140–141.

9. Roberts CGP, Ladenson PW. Hypothyroidism. Lancet 2004; 6: 793–803.

10. Chakera AJ, Pearce HS, Vaidya B. Treatment for primary hypo-tyroidism: current approach. Drug Des Devel Ther 2012; 6: 1–11.

11. Burman KD. Factors affecting thyroid hormone gastrointestinal absorption. Thyroid International 2000; 5: 3–11.

12. Jiskra J, Límanová Z, Vaníčková Z, et al. IgA and IgC antigliadin, IgA anti-tissue trans glutaminase and antiendomysial antibodies in patients with autoimmune thyroid disease and their relationship to thyroidal replacement therapy. Physiol Res 2003; 52(1): 79–88.

13. Centanni M, Gargano L, Cannetieri G, et al. Thyroxine in goiter, Helicobacter pylori infection and chronic gastritis. N Engl J Med 2006; 354: 1787–1793.

14. Cappola A, Fried LP, Arnold LP, et al: Thyroid status, cardiovascular risk, and mortality in older adults. JAMA 2006; 289: 1033–1041.

15. Cooper DS. Approach to the patient with subclinical hyperthyroidism. J Clin Endocrinol Metab 2007; 92: 3–9.

16. Ochs N, Auer R, Bauer DC, et al. Meta-analysis: subclinical thyroid dysfunction and the risk for coronary heart disease and mortality. Ann Intern Med 2008; 148: 832–845.

17. Razvi S, Shakoor A, Vanderpump M, et al. The influence of age on the relationship between subclinical hypothyroidism and hypothyroidism and ischemic heart disease: a metaanalysis. J Clin Endocrinol Metab 2008; 93: 2998–3007.

18. Iacoviello M, Guida P, Guastamacchia E, et al. Prognostic role of sub-clinical hypothyroidism in chronic heart failure outpatients. Curr Pharm Des 2008; 14: 2686–2692.

19. Goichot B, Sapin R, Schlienger JL. Subclinical hyperthyroidism: considerations in defining the lower limit of the thyrotropin reference interval. Clin Chem 2009; 55: 420–424.

20.Vanderpump MP. How should we manage patients with mildly increased serum thyrotrophin concentrations? Clin Endocrinol (Oxf) 2009; Sep 24 [Epub ahead of print].

21. Virgini V, Collet TH, Christ E, et al. Should we treat subclinical hypothyroidism? Rev Med Suisse 2012; 8(331): 501–502, 504–565.

22. Biondi B. Heart failure and thyroid dysfunction. European J Endocrinol 2012; 167: 609–618

23. Orgiazzi J, Virgini VS, Rodondi N, et al. Does subclinical thyroid dysfunction contribute to the frailty syndrome in men over 65 years of age? Clin Thyroidol 2015; 27: 336–333.

24. Lee Ju-Han, Younghye Kim, Jung Woo Choi, et al. The association between papillary thyroid carcinoma and histologically proven Hashimoto‘s thyroiditis: a meta-analysis. Europ J of Endocrinol 2013; 168: 343–349.

25. Jankovic B, Le KT, Hershman JM. Clinical review: Hashimoto‘s thyroiditis and papillary carcinoma: is there a correlation? J Clin Endocrinol metab 2013; 98(2): 474–482.

26. Machová M, Vlček P. Current trends to treatment and follow up of patients with differentiated thyroid carcinoma. Vnitř Lék 2013; 2: 106–112.

27 Vlček P, Nováková D, Vejvalka J, et al. Draft of the best medical treatment in patiens with low risk thyroid cancer. Vnitř Lék 2015; 6(19): 769–777.

28. Din Cy, Lin CL, Huang WS, Kao CH. Risk of breast Cancer in patients with thyroid cancer receiving or not receiving I 131 treatment: a nationwide population based cohortt study. J Nucl med 2015. pil: jnumed 115.164830 (Epub ahead of print)

29. Pearce EN, Kuo JH, Chabot JA, et al. Thyroid cancer survivors are atincreased risk for breast cancer. Clin Thyroidol 2015; 27: 329–331.

30. Limanová Z. Frequent incidence of thyropaties in women with breast cancer. Vnitr Lek 1998; 44(2): 76–82.