DIAGNOSIS AND TREATMENT OF HYPERTHYROIDISM IN THE ELDERLY

Hyperthyroidism is often overlooked in the elderly, since the clinical presentation tends to be different from that in younger patients: Weight loss, fatigue, tachycardia and depression may be present rather than the "classical" symptoms and signs known from the textbooks. In many elderly patients a major goitre is absent and eye signs are usually lacking. The manifestation of thyrotoxicosis is often iatrogenic by iodide exposure of an unsuspected hyperfunctioning thyroid gland. The modern thyroid laboratory tests usually allow for a firm diagnosis, however, changes of the normal ranges with age have to be taken into account. Overt hyperthyroidism in the elderly must - as in younger patients - primarily be treated with thyroid blocking drugs. Later, for the majority radioiodine represents the treatment of choice for definite cure.