Increased risk does not impact older adults with subclinical hypothyroidism
While older adults with hypothyroidism face an elevated risk of death, individuals with subclinical hypothyroidism, a milder form of underactive thyroid, did not face the same risk, according to new research published in The Journal of Clinical Endocrinology & Metabolism.
“Our meta-analysis is the first to evaluate and confirm the association between hypothyroidism and mortality, specifically focusing on an older population,” says Carol Chiung-Hui Peng, MD, of the University of Maryland Medical Center Midtown Campus in Baltimore, Md., and one of the study’s authors.
“Our analysis found individuals with hypothyroidism aged 60 years or older were 26 percent more likely to die from all causes than individuals in the same age range who did not have the thyroid condition,” says co-author, Huei-Kai Huang, MD, of Hualien Tzu Chi Hospital and Tzu Chi University in Hualien, Taiwan.
The researchers reviewed the results of 27 published articles including over 1.1 million older individuals. Although hypothyroidism was associated with all-cause mortality risk, the studies did not find a higher incidence of cardiovascular mortality. Interestingly, studies published in Asia and North America were associated with increased all-cause mortality in the hypothyroid population, while those published in Europe and Oceania were not. Among individuals with hypothyroidism who were 80 years old or older, the researchers found no increased risk of all-cause or cardiovascular mortality.
The mortality difference was not seen in older patients with milder forms of thyroid disease. This study provides further evidence to help guide management of hypothyroidism in older adults.
“In accordance with guidelines, our findings imply that individuals with subclinical hypothyroidism—those who have milder thyroid dysfunction—may not benefit from being treated with synthetic thyroid hormone,” says Kashif M. Munir, MD, associate professor in the division of endocrinology, diabetes and nutrition at the University of Maryland School of Medicine in Baltimore, Md., and another of the study’s authors. “However, treatment should be considered in individuals diagnosed with hypothyroidism, given increased all-cause mortality.”