This report presents key findings on physical, mental, and social aspects of aging using data collected from 50,000 Canadians aged 45-85. It highlights insights related to: physical and psychological health, loneliness and social isolation, caregiving and care receiving, transportation and mobility, work and retirement, physical function, disability and falls, lesbian, gay and bisexual aging, and lifestyle and behaviour, among others. 210 pages. Last reviewed May 2018.
The thyroid is a gland at the base of the neck that releases hormones needed by all cells and organs in the body (1) (2). These hormones influence cell growth and how quickly or slowly the body uses energy (2). Approximately 10% of Canadians have a thyroid condition that affects the functioning of this gland (1).
The main conditions present in most types of thyroid disease are hypothyroidism (thyroid does not produce enough hormones) and hyperthyroidism (thyroid produces too many hormones) (3). Hypothyroidism can cause unusual fatigue or depression, constipation and sensitivity to cold (3). Differently, hyperthyroid conditions often cause unusual nervousness or irritability, diarrhea and heat intolerance (3).
It is important for those with a thyroid condition and their caregiver to understand that these conditions are likely to get better with treatment. Some thyroid disorders develop very gradually and symptoms (signs) may be difficult to notice. At first, small changes in emotions or behaviour may be the only visible signs of a thyroid disorder. After treatment has been initiated, it may take some time before symptoms go away.
Those affected by a thyroid disorder require life-long monitoring by a health care professional (3). Treatment plans should be discussed with the family physician or thyroid specialist.
The most common thyroid problems in older people are hypothyroidism, hyperthyroidism and thyroid nodules. (1)
Why is it important?
Thyroid diseases are very much the diseases of older people and often are not properly diagnosed
4% of older people may have undiagnosed hypothyroidism and 2% have unsuspected hyperthyroidism
Thyroid problems are more common in older women than in men: female to male ratio 10:1 (2)
Clinical examination of women is complicated by the changes in posture and anatomy brought on by thinning of the bone or osteoporosis
Calcified thyroid nodules can cause much discomfort and can appear as rock hard masses or lumps in the chest and be misidentified as metastases of cancer from the breast or stomach that have spread to the lymph glands or the neck.
The most common cause of hypothyroidism (or under activity) in older people is Hashimoto's Thyroiditis. It results in an enlargement of the thyroid gland, caused by an autoimmune condition
The most common cause of hyperthyroidism is Plummer's Disease. It is characterized by a bumpy, lumpy enlarged thyroid with nodules that are overactive.
In hypothyroidism, signs include:
Abnormalities in the cerebellum at the back of the brain which leads to an ataxic or drunken gait;
Aches and pains that are not in or around the joints - rheumatism that is not arthritis;
Carpal Tunnel Syndrome - a compression of an important nerve to our hand in the wrist causes tingling sensations which can be corrected without surgery.
With hyperthyroidism 3/4 of older patients present atypically; 1/3 are clinically euthyroid (have no external symptoms of thyroid dysfunction) while 15% have a syndrome called Apathetic Thyrotoxicosis, a form of hyper-thyroidism which in fact looks like hypothyroidism.
In both conditions there will be a failure to thrive, confusion, depression, falling, walking disturbances, incontinence from immobility, heart failure and change of bowel habits (either constipation or diarrhea). Not only do these signs make it difficult to distinguish hyper from hypothyroidism in the elderly, they are, in fact, the signs of many other common illnesses of older people.
The TSH level is the most accurate indicator of thyroid function and is an even better test than direct measurement of thyroid hormone in the bloodstream.
Signs and symptoms of hypothyroid include: weak slow heart beat; muscular weakness and constant fatigue; sensitivity to cold; thick puffy skin and/or dry skin; slowed mental processes and poor memory; constipation; goiter (increased size of the thyroid)
Signs and symptoms of hyperthyroidism include: rapid forceful heartbeat; tremor; muscular weakness; weight loss in spite of increased appetite; restlessness, anxiety and sleeplessness; profuse sweating and heat intolerance; diarrhea; eye changes and goiter (increased size of the thyroid)