Substitution mit Schilddrüsenhormonen im höheren Lebensalter
| Autor: | K. von Werder, A. von Werder |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
endocrine system
Pediatrics medicine.medical_specialty endocrine system diseases business.industry Thyroid Levothyroxine 030209 endocrinology & metabolism Atrial fibrillation medicine.disease 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Thyroid hormones Internal Medicine medicine In patient 030212 general & internal medicine Medical prescription business hormones hormone substitutes and hormone antagonists Hormone medicine.drug Subclinical infection |
| Zdroj: | Der Internist. 59:1114-1118 |
| ISSN: | 1432-1289 0020-9554 |
| Popis: | Substitution with thyroid hormones is indicated in elderly patients with overt hypothyroidism, especially, when they present with typical symptoms of hypothyroidism. In light of the current study situation, the use of levothyroxine to treat clinical hypothyroidism in elderly patients is still controversial. In a recent double-blind, randomized, placebo-controlled study, levothyroxine provided no apparent benefits in older persons with subclinical hypothyroidism. The impact of levothyroxine therapy in patients with subclinical hypothyroidism on cardiovascular risk is not completely clear. Levothyroxine treatment is safe and free of side effects, when the thyroid-stimulating hormone (TSH) levels remain within the normal range. Prescription of levothyroxine in patients with only slightly elevated TSH levels often leads to overtreatment, which is associated with an increased risk of fractures, neurological and psychological symptoms, and atrial fibrillation. The recommendations of the European Thyroid Association is to treat elderly patients only when the TSH value is greater than 10 mU/l and the patient is symptomatic or the patient has a high cardiovascular risk. The therapeutic TSH range in elderly patients in the case of levothyroxine treatment should be 1.0-5.0 mU/l. Follow-up of the TSH level is mandatory in order to not oversee a developing overt hypothyroidism and to avoid overtreatment in case of levothyroxine treatment. |
| Databáze: | OpenAIRE |
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