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Subclinical thyroid dysfunction symptoms in older adults : cross-sectional study in UK primary care
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McCahon, Deborah, Haque, Sayeed, Parle, James, Hobbs, F. D. Richard and Roberts, Lesley (2020) Subclinical thyroid dysfunction symptoms in older adults : cross-sectional study in UK primary care. British Journal of General Practice, 70 (692). e208-e214. doi:10.3399/bjgp20X708065 ISSN 0960-1643.
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WRAP-symptoms-older-adults-subclinical-thyroid-dysfunction-Roberts-2019.pdf - Accepted Version - Requires a PDF viewer. Download (1030Kb) | Preview |
Official URL: https://doi.org/10.3399/bjgp20X708065
Abstract
Background
Subclinical thyroid dysfunction — abnormal serum thyrotrophin (thyroid-stimulating hormone; TSH) concentrations with normal free thyroxine (FT4) is common in older people. It remains unclear whether individuals with subclinical serum status experience an increased symptom profile.
Aim
To compare the prevalence of those symptoms typically associated with overt thyroid dysfunction in older individuals with a subclinical and euthyroid serum profile.
Design and setting
Cross-sectional study, nested within the Birmingham Elderly Thyroid Study (BETS); from 19 UK general practices.
Method
Adults living in a community setting (aged ≥65 years), without overt thyroid dysfunction or associated treatment, self-reported the presence or absence of 18 symptoms (while serum result naïve). Serum concentrations of TSH and FT4 were measured to establish thyroid status.
Results
A total of 2870 individuals were screened: 2703 (94%) were categorised as euthyroid (normal), 29 (1%) subclinically hyperthyroid, and 138 (5%) subclinically hypothyroid. Symptoms were common in all groups. No significant differences in the prevalence of individual symptoms were observed between the euthyroid and subclinically hypothyroid groups nor in comparison with the subclinically hyperthyroid group. Multivariate logistic regression analysis failed to reveal an association between individual or multiple symptoms and subclinical status.
Conclusion
Findings suggest that subclinical thyroid dysfunction does not confer a symptom burden in older individuals and support adherence to guidelines in the non-treatment of subclinical thyroid dysfunction. GPs may use the findings to reassure older people presenting with symptoms that subclinical thyroid dysfunction is an unlikely explanation. The presence of persistently abnormal TSH concentrations may be linked to long-term risks of cardiovascular disease, especially atrial fibrillation, but whether this should prompt treatment and whether such treatment alters vascular outcomes is unknown.
Item Type: | Journal Article | ||||||||||||||||||||||||
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Subjects: | R Medicine > RC Internal medicine | ||||||||||||||||||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Thyroid gland -- Diseases -- Genetic aspects, Hypothyroidism -- Treatment, Older people, Thyroid gland function tests, Hypothyroidism | ||||||||||||||||||||||||
Journal or Publication Title: | British Journal of General Practice | ||||||||||||||||||||||||
Publisher: | Royal College of General Practitioners | ||||||||||||||||||||||||
ISSN: | 0960-1643 | ||||||||||||||||||||||||
Official Date: | March 2020 | ||||||||||||||||||||||||
Dates: |
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Volume: | 70 | ||||||||||||||||||||||||
Number: | 692 | ||||||||||||||||||||||||
Page Range: | e208-e214 | ||||||||||||||||||||||||
DOI: | 10.3399/bjgp20X708065 | ||||||||||||||||||||||||
Status: | Peer Reviewed | ||||||||||||||||||||||||
Publication Status: | Published | ||||||||||||||||||||||||
Access rights to Published version: | Restricted or Subscription Access | ||||||||||||||||||||||||
Date of first compliant deposit: | 20 December 2019 | ||||||||||||||||||||||||
Date of first compliant Open Access: | 27 February 2021 | ||||||||||||||||||||||||
RIOXX Funder/Project Grant: |
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