The prevalence of disorders of the thyroid gland increases with age, especially in women. Overt thyroid hypofunction in old age may manifest clinically with symptoms and signs similar to the changes that normally accompany aging itself or as disorders of other organs. For this reason, a high index of suspicion is essential to detect hypothyroidism in elderly patients with multiple comorbidities, nutritional abnormalities and/or polypharmacy. The decision to treat overt hypothyroidism is generally straightforward. Conversely, there is still controversy over the decision to treat or not subclinical hypothyroidism. The current recommendation indicates the need to consider treatment on an individual basis, with particular attention to the possible beneficial effect on the quality of life, because there is no sufficient evidence about the need of therapy in all patients with subclinical hypothyroidism. The therapy of choice for hypothyroidism remains oral sodium levothyroxine replacement. However, about one third of patients treated with levothyroxine is under- or over-treated, leading to an increased risk of cardiac arrhythmias, osteoporotic fractures and/or ischemic coronary events. The most common reasons for an unsatisfactory replacement include lack of adherence and altered absorption of the active ingredient due to gastrointestinal pathologies and/or concomitant use of other drugs. In addition, the patient with history of stroke or other types of dysphagia may have difficulty swallowing tablets. Therefore, the availability of an oral solution formulation of sodium levothyroxine represents a valuable opportunity for the proper treatment of hypothyroidism in the older person.
|Numero di pagine||10|
|Rivista||GIORNALE DI GERONTOLOGIA|
|Stato di pubblicazione||Published - 2013|
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