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Elderly patients with high TSH levels may not benefit from treatment
Previous studies have examined thyroid function in elderly patients and the conflicting evidence surrounding function and mortality in this patient population. However, new data have shown that thyroid-stimulating hormone levels increase over time, and the elevation is not linked to an increase or decrease in mortality.
“An increasing number of people live into their 80s and 90s, it is important to know how to manage their health, including thyroid function,” researcher Anne R. Cappola, MD, ScM, of the division of endocrinology, diabetes and metabolism of the Perelman School of Medicine at the University of Pennsylvania, said in a press release. “Our study shows that a gradual increase of TSH occurs during healthy aging and that mild increases in TSH are not harmful in the oldest old.”
Anne R. Cappola
Researchers studied 843 patients (mean age, 85 years) from the Cardiovascular Health Study All Stars Study, which was conducted between 1989 and 1992, who were not taking thyroid medications and underwent thyroid function testing in 2005 and 2006.
According to data, there was a statistically significant 13% increase in TSH; 1.7% increase in free thyroxine; and 13% decrease in total triiodothyronine during the 13-year period. During a median follow-up of 5.1 years, researchers reported 287 deaths.
Data indicated there was no link between subclinical hypothyroidism (HR=0.97; 95% CI, 0.66-1.43); TSH level (HR=0.94 per mU/L; 95% CI, 0.88-1.01) or persistent thyroid peroxidase antibody positivity (HR=1.09; 95% CI, 0.62-1.92), and mortality. Upon further investigation, researchers found that free T4 and morality were positively associated (HR=2.51 per ng/dL; 95% CI, 1.19-5.33).
“Our findings suggest that reflexively treating mild elevations in TSH in those of advanced age is unnecessary. Further studies are needed to determine threshold levels of thyroid function that would benefit from intervention,” researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.