Hypothyroidism symptoms and signs in an older person

Source: Harvard Health Publishing, Harvard Medical School - August 7, 2021

Some people over age 60 have few, if any, symptoms of an underactive thyroid gland (hypothyroidism), while others experience the same symptoms younger people do. Still, others have hypothyroidism symptoms that are not typical at all, making the diagnosis even more difficult. Any of the following signs and symptoms can indicate hypothyroidism in an older person.

Many people diagnosed with a thyroid condition are surprised that such a small gland can have such a profound impact on overall health and well-being. But the thyroid gland plays an enormous role in human health. Throughout life, this busy gland is constantly producing hormones that influence metabolism. When disease causes your thyroid gland to slack off and underproduce thyroid hormone, or overwork and produce too much of it, you'll know something isn't right.

Unexplained high cholesterol. High cholesterol is sometimes the only evidence of an underactive thyroid in an older person. Because this sign may stand alone, high cholesterol warrants a thyroid evaluation.

Heart failure. Reduced blood volume, weaker contractions of the heart muscle, and a slower heart rate—all caused by low thyroid hormone levels—can contribute to heart failure, when your heart can't pump out blood as effectively as it should The ineffective pumping may cause subtle symptoms such as feeling less energetic or just walking more slowly. In more advanced stages, fluid can back up in the lungs and legs causing shortness of breath and leg swelling.

Bowel movement changes. An older person with hypothyroidism might have constipation because stool moves more slowly through the bowels.

Joint or muscle pain. Vague joint pain is a classic hypothyroidism symptom. It sometimes is the only symptom of hypothyroidism in an older person. Many people experience general muscle aches, particularly in large muscle groups like those in the legs.

Psychiatric problems. Clinical depression—a common symptom in younger people with hypothyroidism—can also affect older people with the condition. The difference is that in older people it can be the only hypothyroidism symptom. Some older adults also develop psychosis with delusional behavior or hallucinations.

Cognitive decline. Older people with a very underactive thyroid gland can sometimes be misdiagnosed as dementia. That's why doctors usual order thyroid testing in people with new cognitive decline. If you or a loved one is being evaluated for dementia, make sure that a thyroid test is part of the evaluation.

If you're always cold or tired, you can't lose weight, you have brittle hair and fingernails, or you have other unexplained health issues, the answer may be "yes."

Untreated, a thyroid disease can make you feel lousy. It can also increase your odds of having high cholesterol, developing atherosclerosis, and having a heart attack.

Fortunately, a simple blood test makes it possible to give you a precise account of how well your thyroid gland is functioning and help determine the cause of the problem. Then, for many forms of thyroid disease, treatment is usually a matter of taking the correct amount of medication. You can go on with your life with your disease in check.

But what are the risk factors for thyroid disease? The symptoms? The treatments? You'll find out in Thyroid Disease, a Special Health Report from Harvard Medical School. It explains the mechanics of the thyroid gland and the disorders that can trigger a thyroid condition. Most important, it gives you the information you need to work with your doctor to quickly and effectively detect thyroid disease and to optimize a treatment plan that will work best for you.

The report explains how thyroid hormone controls your body's metabolism and what occurs when your thyroid produces too little thyroid hormone (called hypothyroidism) or too much (called hyperthyroidism). You will learn about medications that can cause temporary hypothyroidism; about Graves' disease, the most common cause of hyperthyroidism; and the role of nodules and goiters in thyroid disease for older adults.