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Thyroid disease in the elderly. Special features, changes in management.

Many changes in thyroid physiology occur with aging. These changes correlate with major alterations in the normal physiologic functioning of the thyroid and with changes in thyroid hormone levels as measured by radioimmunoassay. Clinical manifestations of thyroid disease in elderly patients may be somewhat different than in younger patients. Both hyperthyroidism and hypothyroidism can be more difficult to diagnose in elderly patients because of subtle changes in disease presentation. The incidence of certain thyroid diseases, from benign single nodules to malignant anaplastic carcinoma, increases with age. A deliberate and cautious approach is needed when treating thyroid disease in the elderly, who are inherently more fragile than younger patients.