If you’re an older adult, you may consider fatigue, weight gain and mental fogginess to be inevitable signs of aging.
But for many women, these subtle symptoms may point to a thyroid problem. Thyroid disease is common, and the risk increases with age. Underactive thyroid, or hypothyroidism, is five times more common in women than men and is seen in up to 15 percent of women older than age 65.
“The thyroid gland produces hormones that affect how our bodies use energy. This impacts all major functions, from metabolism and digestion to heart rate, mental clarity and more,” explains Carmel Fratianni, MD, endocrinologist at Riddle Hospital, part of Main Line Health. “As endocrinologists, we have to look at the whole patient, since untreated thyroid disease can affect every organ system in the body.”
Recognizing the symptoms
Symptoms of hypothyroidism can include:
- Heavy menstrual periods or infertility
- Joint aches
- Hair loss
- Dry skin
- Feeling cold
“Patients may have low heart rates, low sodium levels, anemia and even high cholesterol levels,” says Dr. Fratianni. “Some patients can continue to have symptoms of hypothyroidism even when they’re taking thyroid medicine, especially if they are also taking calcium, iron or acid-blocking medications, which can block the absorption of thyroid pills. So it’s important to review your entire list of medications and supplements with your doctor.”
Symptoms of an overactive thyroid, or hyperthyroidism, can include weight loss and a racing heartbeat. Older adults with hyperthyroidism typically have fewer symptoms than younger adults, although the risk to their health is greater. Too much thyroid hormone can cause bone loss, osteoporosis and irregular heartbeats such as atrial fibrillation.
Diagnosing older adults
Diagnosing thyroid disease in older adults can be challenging since the symptoms can mimic many other conditions. In addition, determining normal levels of thyroid hormone for adults in their 80s or 90s is controversial. “In fact, up to one-third of patients older than age 65 may be overtreated for their thyroid condition,” says
Dr. Fratianni. “That’s why treatment needs to be individualized after looking at the whole patient. If you suspect you have a thyroid problem, the first step is to talk with your doctor.”