August 1, 2002

Many people may blame their lack of energy, thinning hair, frequently feeling chilled, or poor memory on growing older; however, these are also symptoms of hypothyroidism, a common malady that affects more than five million people, mostly older women.

Hypothyroidism is a thyroid disease that causes the bodyâ??s metabolism to slow down. It occurs when there is too little thyroid hormone in the blood. Other common symptoms in adults include depression, constipation, muscle cramps, drowsiness and slow heart rate. Some patients may also exhibit a husky voice and dry and coarse skin.

Recent research at UNT Health Science Center found that these symptoms alone are not enough to diagnose hypothyroidism. Geriatric patients with normal thyroid function and those with hypothyroidism both report many of the same symptoms during an initial comprehensive exam. Researchers found that a quarter of the patients in the study had been diagnosed with the condition but that nearly all reported some of the symptoms.

As a result, the clinicians now believe that the only way to accurately diagnose the condition is through routine screening of every new geriatric patient.

â??Older patients have many symptoms that could be â??hypothyroidism symptoms,â?? but may also be due to other illnesses and chronic diseases, or even normal aging,â? said Janice Knebl, DO, chief of geriatrics at UNT Health Science Center. â??Most of our patients have symptoms that could be from hypothyroidism, so we routinely measure thyroid function as a diagnostic test.â?

Medicare pays for thyroid tests as a diagnostic tool when thyroid dysfunction is suspected, but doesnâ??t pay for the tests to screen for thyroid dysfunction.

â??We need to consider paying for TSH as a screen since it is a prevalent condition in this patient population and is very treatable,â? Dr. Knebl said.

â??Routine screening of thyroid dysfunction is probably much less expensive than the medical costs of treating the complications associated with undiagnosed hypothyroidism,â? said Jennifer Weatherly, DO, who conducted the research.

Dr. Weatherly, a resident in family medicine, said that when left untreated, hypothyroidism can cause significant health problems in the elderly, primarily by aggravating cardiovascular disease. Patients with hypothyroidism also were significantly more likely to have a history of depression, anxiety and angina than those without the condition.

James Hall, PhD, also worked with Dr. Weatherly and Dr. Knebl on the research. Dr. Hall said that routine testing rules out other conditions so that â??we can then initiate the optimal treatment for every patient.â?

Clinician researchers reviewed the charts of 140 new patients in the geriatric clinic in the department of internal medicine. This was the first research study to focus on an outpatient clinic population. Only two other studies have focused on hypothyroidism in the elderly, but looking at an outpatient clinic population provides new insight into the incidence of the disease, Dr. Weatherly said.


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