Normal serum TSH ranges are higher in the people age 70 to 80 years; based on this, higher serum TSH goals may be needed as a patient ages.
The American Thyroid Association (ATA) suggests raising the target serum TSH to 4-6 m IU/L for 70 years-old and up
The thyroid is a small, butterfly-shaped hormone-producing gland located at the front of the neck. The thyroid gland secretes two main hormones:
thyroxine (T-4) and triiodothyronine (T-3).
These hormones regulate energy levels, metabolism of fats, proteins and carbohydrates, body temperature, heart rate.
Hypothyroidism happens when the underactive thyroid gland doesn't make enough hormones.
Hypothyroidism affects up to 10% of the general population (5% undiagnosed). An autoimmune disease called Hashimoto's disease where our body makes antibodies that attack healthy thyroid tissues is the most common cause of hypothyroidism in societies with enough iodine consumption . Thyroid gland damage occurs when sensitized T-lymphocytes and/or autoantibodies bind to thyroid cell membranes causing inflammation and breaking them.
Symptoms of hypothyroidism are non-specific and include mild to moderate weight gain, lack of interest, fatigue, poor concentration, depression, and menstrual irregularities. Consequences of untreated or under-treated hypothyroidism may include low quality of health, cardiovascular disease and increased mortality.
Hypothyroidism is diagnosed by a simple blood test, where a patient has serum thyroid-stimulating hormone (TSH) concentrations above and thyroxine concentrations below the normal reference range.
Levothyroxine has long been the main medication for managing hypothyroidism and is one of the world’s most widely prescribed medicines. (cost range: $4-$15 based on dose for 30 days supply). Liothyronine at Olive/Carethera pharmacies is $12 for 30 days supply with prescription.
Adult dose: levothyroxine is usually prescribed at a starting dose of 1.6 µg/kg/day, which is then titrated to achieve therapeutic range TSH levels (0.4–4.0 mIU/L). The American Thyroid Association (ATA) suggests raising the target serum TSH to 4-6 mIU/L in
References:
1. Chiovato L, Magri F, Carlé A. Hypothyroidism in Context: Where We've Been and Where We're Going. Adv Ther. 2019 Sep;36(Suppl 2):47-58. doi: 10.1007/s12325-019-01080-8. Epub 2019 Sep 4. PMID: 31485975; PMCID: PMC6822815.
2. https://pro.endocrineweb.com/hypothyroidism/american-thyroid-association-guidelines-treatment-hypothyroidism
3. https://www.thyroid.org/ (accessed 01/27/2023)
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