‘Normal’ TSH and FT4 concentrations change with age, and the failure to consider those changes in assessment can lead to misdiagnosis and overtreatment.
The reference ranges of thyroid-stimulating hormone and free thyroxine , known to vary in children compared with adults, also shift considerably in older age, to the degree that the use of standard ranges in older patients without age adjustment results in significant overdiagnosis and unnecessary treatment for subclinical or overt hypothyroidism, findings from a largest-of-its-kind analysis showed.
Patients were stratified into age groups spanning 2 years in children between the ages of 2 and 18 years. They found that use of the age-specific reference intervals resulted in a decrease in diagnoses of subclinical hypothyroidism from 13.1% to 8.6% in women aged 50-60 years and from 22.7% to just 8.1% for women aged 90-100 years.
“Implementation of adult age-specific reference intervals for TSH in clinical practice remains a debated topic,” the authors wrote. “However, our results indicate that age-specific reference intervals, especially for TSH, are clinically significant.
“The take-home message from this is that by implementing age-specific reference ranges for adults, we will have less older persons with subclinical hypothyroidism,” first author Annemieke C.
Thyroid Disorder Thyroid Disease Thyroid Dysfunction Thyroid Hyperthyroidism Children Child Childhood Pediatrics Kids Clinical Guidelines Guidelines Geriatrics Elder Care Geriatric Medicine Older Adults Seniors Senior Citizens Elderly Ohio Elderly/Concerns Of Older Adults Elderly Clinical Research Clinical Trials Clinical Studies Pre-Clinical Trial
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