Tsh normal range for female by age

  1. Hypothyroidism in the Elderly: Who Should Be Treated and How?
  2. Screening for Thyroid Dysfunction: Recommendation Statement


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Hypothyroidism in the Elderly: Who Should Be Treated and How?

Abstract Hypothyroidism is among the most frequent chronic diseases in the elderly, and levothyroxine ( l-T4) is worldwide within the 10 drugs more prescribed in the general population. Hypothyroidism is defined by increased serum thyroid-stimulating hormone (TSH) values and reduced circulating free thyroid hormones, whereas subclinical hypothyroidism (sHT) is characterized by free hormone fractions within the normal ranges and has been divided into two classes, depending on circulating TSH levels (above or below 10 mIU/L). Given that during aging, a natural trend toward higher values of circulating TSH has been reported, it is necessary to verify carefully the diagnosis of sHT to tailor an appropriate follow-up and ad hoc therapy, avoiding unnecessary or excessive treatment. In the current review, we evaluate the state of the art on hypothyroidism in the elderly with special focus on the effect of sHT on cognition and the cardiovascular system function. We also summarize the recommendations for a correct diagnostic workup and therapeutic approach to older people with an elevated TSH value, with special attention to the presence of frailty, comorbidities, and poly therapy. In conclusion, personalized therapy is crucial in good clinical practice, and in the management of older patients with sHT, multiple factors must be considered, including age-dependent TSH cutoffs, thyroid autoimmunity, the burden of comorbidities, and the possible presence of frailty. l-T4 is the drug o...

Screening for Thyroid Dysfunction: Recommendation Statement

Population Nonpregnant, asymptomatic adults Recommendation No recommendation Grade: I statement (insufficient evidence) Risk assessment Risk factors for an elevated thyroid-stimulating hormone (TSH) level include female sex, advancing age, white race, type 1 diabetes, Down syndrome, family history of thyroid disease, goiter, previous hyperthyroidism, and external-beam radiation in the head and neck area. Risk factors for a low TSH level include female sex; advancing age; black race; low iodine intake; personal or family history of thyroid disease; and ingestion of iodine-containing drugs, such as amiodarone. Screening tests The primary screening test for thyroid dysfunction is serum TSH testing. Multiple tests over 3 to 6 mo should be performed to confirm or rule out abnormal findings. Follow-up testing of serum thyroxine (T4) levels in persons with persistently abnormal TSH levels can differentiate between subclinical (normal T4) and “overt” (abnormal T4) thyroid dysfunction. Treatment and interventions Hypothyroidism is treated with oral T4 monotherapy (levothyroxine sodium). Consensus is lacking on the appropriate point for clinical intervention, especially for TSH levels < 10.0 mIU/L. Hyperthyroidism is treated with antithyroid medications (e.g., methimazole) or nonreversible thyroid ablation therapy (e.g., radioactive iodine or surgery). Treatment is generally recommended for patients with a TSH level that is undetectable or < 0.1 mIU/L, particularly those with overt ...