scholarly journals Subclinical thyroid dysfunction symptoms in older adults: cross-sectional study in UK primary care

2020 ◽  
Vol 70 (692) ◽  
pp. e208-e214
Author(s):  
Deborah McCahon ◽  
M Sayeed Haque ◽  
James Parle ◽  
FD Richard Hobbs ◽  
Lesley M Roberts

BackgroundSubclinical 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.AimTo compare the prevalence of those symptoms typically associated with overt thyroid dysfunction in older individuals with a subclinical and euthyroid serum profile.Design and settingCross-sectional study, nested within the Birmingham Elderly Thyroid Study (BETS); from 19 UK general practices.MethodAdults 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.ResultsA 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.ConclusionFindings 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.

2021 ◽  
Vol 09 (23) ◽  
pp. 1904-1908
Author(s):  
Vishal M. Kalmani ◽  
Madhuvan H.S ◽  
Ravishankar S.N. ◽  
Thimmareddy S.R ◽  
Kavana M

BACKGROUND Thyroid abnormalities are seen in most of the patients suffering from liver cirrhosis. Cirrhosis of the liver is the major cause of morbidity and mortality worldwide. Cirrhosis plays a vital role in the thyroid hormone metabolism and thyroid hormone circulation by producing thyroid binding globulin. Hence, it is seen that the thyroid dysfunction is associated with the severity of liver disease. We wanted to study the changes in the levels of thyroid hormones in patients suffering from alcoholic liver cirrhosis. METHODS In this cross-sectional study, 50 patients who were admitted to the IP department and ICU of General Medicine Department of Akash Hospital, Devanahalli, for symptoms of cirrhosis of liver were evaluated for their thyroid profile along with other relevant investigations. RESULTS Among the 50 patients studied, 43 were male and 7 were female. 17 patients had an increase in their thyroid stimulating hormone (TSH). These patients also had a significant association with various LFT parameters such as indirect bilirubin, AST, ALT, APS, and GGT. These 17 patients who had increase in TSH also had associated hepatic complications such as - jaundice (41 %), hepatic encephalopathy (35.29 %), bleeding varices (29.4 %), and portal hypertension (82.35 %). CONCLUSIONS Thyroid abnormalities are not uncommon in patients with cirrhosis. Hypothyroidism is the most common abnormality that was detected. Rate of complications is also high in patients with elevated levels of TSH. A fair amount of suspicion is required for detecting thyroid abnormalities in patients suffering from cirrhosis. KEYWORDS Cirrhosis, Thyroid Hormone, Hypothyroidism, Hyperthyroidism, Thyroiditis


2019 ◽  
Vol 9 (2) ◽  
pp. 87-90
Author(s):  
Karanam Madhuri ◽  
◽  
Rishi Kumar Venkatachalam ◽  
A Nasreen Begum ◽  
Shamsheer Khan P ◽  
...  

Author(s):  
Rachel J. Viggars ◽  
Andrew Finney ◽  
Barnabas Panayiotou

Summary Background More people are living with frailty and requiring additional health and support services. To improve their management, the “Frailty: Core Capability Framework” in the United Kingdom recommends frailty education for older individuals, their families, carers and health professionals. We performed a systematic review of specific educational programmes for these groups. Methods Electronic databases were searched using dedicated search terms and inclusion criteria. To improve accuracy, two reviewers carried out the screening and selection of research papers. Information from included studies was collected using a tailored data extraction template, and quality appraisal tools were used to assess the rigour of the studies. The findings were analysed to identify key themes. Results A total of 11 studies met the criteria and were included in the review. The study populations ranged from 12 to 603 and the research designs were heterogeneous (6 qualitative; 2 randomised controlled trials; 1 quasi-experimental; 1 mixed methods; 1 cross-sectional study). Whilst some methodological shortcomings were identified, all studies contributed valuable information. The results underwent narrative synthesis, which elucidated four thematic domains: (1) accessibility of educational programmes, (2) empowerment, (3) self-care, and (4) health promotion (especially exercise and nutrition). Conclusion Educational programmes for older people, their carers and health professionals are important for effective frailty prevention and management. To be maximally beneficial, they should be easily accessible to all target populations and include empowerment, self-care and health promotion. Further research should explore the formulation of widely applicable, user-friendly programmes and delivery formats that can be tailored to different client groups.


2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Yun Zhang ◽  
Qiong Wang ◽  
Quanzhong Li ◽  
Ping Lu

Objectives. The concept now emerging is that higher thyroid-stimulating hormone (TSH) and lower thyroid hormone levels within the euthyroid range may adversely affect atherosclerosis. The present study aimed to investigate the potential associations between thyroid parameters and hyperhomocysteinaemia in a cohort of euthyroid diabetic subjects.Material and Methods. Two hundred and seventy-three euthyroid diabetic subjects (167 males and 106 females) were consecutively recruited in this cross-sectional study. Clinical and biomedical data was collected.Results. TSH level was higher in females than males. Compared to normal-homocysteine group, hyperhomocysteinaemia group was more likely to be elderly, males, with longer diabetes history, and with lower diastolic blood pressure. Free thyroxine (FT4) level was lower in hyperhomocysteinaemia group than in normal-homocysteine group; however, it was not statistically significant. Adjusted for age, sex, body mass index, duration of diabetes, blood pressure, fasting glucose, total cholesterol, and triglyceride in logistic regression analyses, hyperhomocysteinaemia was significantly correlated with FT4 (P=0.021). No significant association was found with TSH or free triiodothyronine. When analyzed in subjects with TSH < 2.5 uIU/mL separately, we got similar results.Conclusions. In conclusion, we identified a relation between hyperhomocysteinemia and FT4 in a group of euthyroid diabetic patients.


BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e055625
Author(s):  
T Muhammad ◽  
Trupti Meher ◽  
T V Sekher

ObjectiveThe study aims to explore the associations of elder abuse, crime victimhood and perceived safety with depression among older adults and examine the interactive effects of sex and place of residence in those associations.DesignA cross-sectional study was conducted using a large survey data.Setting and participantsThe study used data from the Longitudinal Ageing Study in India wave 1 (2017–2018). The effective sample size was 31 464 older adults (aged 60 years or older).Primary and secondary outcome measuresThe outcome variable was major depression, calculated using Short Form Composite International Diagnostic Interview. Descriptive statistics along with bivariate and multivariate analyses were performed to fulfil the objectives.Results5.22% of the older adults (n=1587) experienced abuse in the past 1 year. 1.33% of the older individuals (n=402) were victims of a violent crime, and 14.30% (n=1886) perceived an unsafe neighbourhood. Also, 8.67% of the older adults (n=2657) were suffering from depression. Older adults who were abused had 2.5 odds of suffering from depression (adjusted OR (AOR): 2.47, CI: 1.96 to 3.10) and victims of a violent crime were 84% more likely to be depressed (AOR: 1.84, CI: 1.15 to 2.95) compared with their counterparts. Besides, older individuals who perceived as living in unsafe neighbourhood were 61% more likely to be depressed (AOR: 1.61, CI: 1.34 to 1.93) compared with their counterparts. In the interaction analysis, older women who reported abuse had higher odds of suffering from depression (AOR: 3.27; CI: 2.34 to 4.57) compared with older men who were not abused. Similar result was found in older adults reporting abuse and residing in rural areas (AOR: 3.01, CI: 2.22 to 4.07) compared with those urban residents reporting no abuse.ConclusionsHealthcare providers should pay more attention to the mental health implications of elder abuse, crime victimhood and perceived safety to grasp the underlying dynamics of the symptomology of late-life depression.


2021 ◽  
Vol 8 (5) ◽  
pp. 183-186
Author(s):  
Channanayaka Chandrashekhar ◽  
Manovihari Vuyyuru ◽  
Prajwala Hassan Vasudev ◽  
George Mathew Panachiyil ◽  
Tirin Babu

Sign in / Sign up

Export Citation Format

Share Document