Skip to main content
Erschienen in: Geriatrie-Report 2/2019

31.05.2019 | Hypothyreose | Endokrinologie

Ziele und Gefahren

Substitution mit Schilddrüsenhormonen: Seien Sie bei Älteren zurückhaltend

verfasst von: Dr. Alexander von Werder, Prof. Dr. Klaus von Werder

Erschienen in: Geriatrie-Report | Ausgabe 2/2019

Einloggen, um Zugang zu erhalten

Zusammenfassung

Während die manifeste Schilddrüsenunterfunktion in allen Altersgruppen eine klare Therapieindikation darstellt, birgt die Substitution mit Schilddrüsenhormonen bei subklinischer Hypothyreose insbesondere bei alten Patienten Risiken und sollte kritisch hinterfragt werden.
Literatur
1.
Zurück zum Zitat Atzmon G, Barzilai N, Hollowell JG et al (2009) Extreme longevity is associated with increased serum thyrotropin. J Clin Endocrinol Metab 94:1251–1254CrossRef Atzmon G, Barzilai N, Hollowell JG et al (2009) Extreme longevity is associated with increased serum thyrotropin. J Clin Endocrinol Metab 94:1251–1254CrossRef
2.
Zurück zum Zitat Baloch Z, Carayon P, Conte-Devolx B et al (2003) Laboratory medicine practice guidelines. Laboratory support for the diagnosis and monitoring of thyroiddisease. Thyroid 13:3–126CrossRef Baloch Z, Carayon P, Conte-Devolx B et al (2003) Laboratory medicine practice guidelines. Laboratory support for the diagnosis and monitoring of thyroiddisease. Thyroid 13:3–126CrossRef
3.
Zurück zum Zitat van den Beld AW, Visser TJ, Feelders RA et al (2005) Thyroidhormoneconcentrations,disease,physical function, and mortality in elderly men. J Clin Endocrinol Metab90:6403–6409CrossRef van den Beld AW, Visser TJ, Feelders RA et al (2005) Thyroidhormoneconcentrations,disease,physical function, and mortality in elderly men. J Clin Endocrinol Metab90:6403–6409CrossRef
4.
Zurück zum Zitat Biondi B, Cooper DS(2008)Theclinical significance of subclinical thyroid dysfunction. Endocr Rev 29:76–131CrossRef Biondi B, Cooper DS(2008)Theclinical significance of subclinical thyroid dysfunction. Endocr Rev 29:76–131CrossRef
5.
Zurück zum Zitat Bremner AP, Feddema P, Leedman PJ et al (2012) Age-related changes in thyroid function: a longitudinal studyofa community-basedcohort. JClinEndocrinolMetab97:1554–1562 Bremner AP, Feddema P, Leedman PJ et al (2012) Age-related changes in thyroid function: a longitudinal studyofa community-basedcohort. JClinEndocrinolMetab97:1554–1562
6.
Zurück zum Zitat Canaris GJ, Manowitz NR, Mayor G, Ridgway EC (2000) The Colorado thyroid disease prevalence study. ArchInternMed160:526–534 Canaris GJ, Manowitz NR, Mayor G, Ridgway EC (2000) The Colorado thyroid disease prevalence study. ArchInternMed160:526–534
7.
Zurück zum Zitat Chikunguwo S, Brethauer S, Nirujogi V et al (2007) Influence of obesity and surgical weight loss on thyroid hormone levels. Surg Obes Relat Dis 3:631–636CrossRef Chikunguwo S, Brethauer S, Nirujogi V et al (2007) Influence of obesity and surgical weight loss on thyroid hormone levels. Surg Obes Relat Dis 3:631–636CrossRef
8.
Zurück zum Zitat Chueire VB, Romaldini JH, Ward LS (2007) Subclinical hypothyroidism increases the risk for depression in the elderly. Arch Gerontol Geriatr 44:21–28CrossRef Chueire VB, Romaldini JH, Ward LS (2007) Subclinical hypothyroidism increases the risk for depression in the elderly. Arch Gerontol Geriatr 44:21–28CrossRef
9.
Zurück zum Zitat Escobar-Morreale HF, Botella-Carretero JI, Escobar del Rey F, Morreale de Escobar G (2005) REVIEW: treatmentofhypothyroidismwithcombinationsof levothyroxine plus liothyronine. J Clin Endocrinol Metab90:4946–4954CrossRef Escobar-Morreale HF, Botella-Carretero JI, Escobar del Rey F, Morreale de Escobar G (2005) REVIEW: treatmentofhypothyroidismwithcombinationsof levothyroxine plus liothyronine. J Clin Endocrinol Metab90:4946–4954CrossRef
10.
Zurück zum Zitat Flynn RW, Bonellie SR, Jung RT et al (2010) Serum thyroid-stimulating hormone concentration and morbidity from cardiovascular disease and fractures in patients on long-term thyroxine therapy. JClinEndocrinolMetab 95:186–193 Flynn RW, Bonellie SR, Jung RT et al (2010) Serum thyroid-stimulating hormone concentration and morbidity from cardiovascular disease and fractures in patients on long-term thyroxine therapy. JClinEndocrinolMetab 95:186–193
11.
Zurück zum Zitat Gärtner R, Reincke M (2008) Substitution von Schilddrüsenhormonen. Internist49:538–544CrossRef Gärtner R, Reincke M (2008) Substitution von Schilddrüsenhormonen. Internist49:538–544CrossRef
12.
Zurück zum Zitat Gharib H, Tuttle RM, Baskin HJ et al (2005) Consensus statement #1: subclinical thyroid dysfunction: a joint statementonmanagement fromtheAmerican Association of Clinical Endocrinologists, the American Thyroid Association and The Endocrine Society. JClinEndocrinolMetab90:581–585 Gharib H, Tuttle RM, Baskin HJ et al (2005) Consensus statement #1: subclinical thyroid dysfunction: a joint statementonmanagement fromtheAmerican Association of Clinical Endocrinologists, the American Thyroid Association and The Endocrine Society. JClinEndocrinolMetab90:581–585
13.
Zurück zum Zitat Gussekloo J, van Exel E, de Craen AJ et al (2004) Thyroid status, disability and cognitive function, andsurvival inoldage. JAMA292:2591–2599 Gussekloo J, van Exel E, de Craen AJ et al (2004) Thyroid status, disability and cognitive function, andsurvival inoldage. JAMA292:2591–2599
14.
Zurück zum Zitat Hollowell JG, Staehling NW, Flanders WD et al (2002) Serum TSH, T 4, and thyroid antibodies in the United States population (1988 to 1994): NationalHealth andNutrition Examination Survey (NHANESIII). JClinEndocrinolMetab87:489–499 Hollowell JG, Staehling NW, Flanders WD et al (2002) Serum TSH, T 4, and thyroid antibodies in the United States population (1988 to 1994): NationalHealth andNutrition Examination Survey (NHANESIII). JClinEndocrinolMetab87:489–499
15.
Zurück zum Zitat Hyland KA, Arnold AM, Lee JS, Cappola AR (2013) Persistent subclinical hypothyroidism and cardiovascularriskintheelderly:thecardiovascular healthstudy. JClinEndocrinolMetab98:533–540 Hyland KA, Arnold AM, Lee JS, Cappola AR (2013) Persistent subclinical hypothyroidism and cardiovascularriskintheelderly:thecardiovascular healthstudy. JClinEndocrinolMetab98:533–540
16.
Zurück zum Zitat Kratzsch J, Fiedler GM, Leichtle A et al (2005) New reference intervals for thyrotropin and thyroid hormones based on National Academy of Clinical Biochemistry criteria and regular ultrasonography of thethyroid.ClinChem51:1480–1486 Kratzsch J, Fiedler GM, Leichtle A et al (2005) New reference intervals for thyrotropin and thyroid hormones based on National Academy of Clinical Biochemistry criteria and regular ultrasonography of thethyroid.ClinChem51:1480–1486
17.
Zurück zum Zitat Parle J, Roberts L, Wilson S et al (2010) Arandomized controlled trial of the effect of thyroxine replacement on cognitive function in community-livingelderlysubjectswith subclinical hypothyroidism: the Birmingham Elderly Thyroid study. JClinEndocrinolMetab95:3623–3632 Parle J, Roberts L, Wilson S et al (2010) Arandomized controlled trial of the effect of thyroxine replacement on cognitive function in community-livingelderlysubjectswith subclinical hypothyroidism: the Birmingham Elderly Thyroid study. JClinEndocrinolMetab95:3623–3632
18.
Zurück zum Zitat Pearce SH, Brabant G, Duntas LH et al (2013) 2013 ETA guideline: management of subclinical hypothyroidism. EurThyroidJ2:215–228 Pearce SH, Brabant G, Duntas LH et al (2013) 2013 ETA guideline: management of subclinical hypothyroidism. EurThyroidJ2:215–228
19.
Zurück zum Zitat Psaty BM, Anderson M, Kronmal RA et al (2004) The association between lipid levels and the risks of incidentmyocardial infarction, stroke, and total mortality: the Cardiovascular Health Study. J Am GeriatrSoc52:1639–1647CrossRef Psaty BM, Anderson M, Kronmal RA et al (2004) The association between lipid levels and the risks of incidentmyocardial infarction, stroke, and total mortality: the Cardiovascular Health Study. J Am GeriatrSoc52:1639–1647CrossRef
20.
Zurück zum Zitat Sawin CT, Geller A, Wolf PA et al (1994) Lowserum thyrotropin concentrations as a risk factor for atrial fibrillation in older persons. N Engl J Med 331:1249–1252CrossRef Sawin CT, Geller A, Wolf PA et al (1994) Lowserum thyrotropin concentrations as a risk factor for atrial fibrillation in older persons. N Engl J Med 331:1249–1252CrossRef
21.
Zurück zum Zitat Stott DJ, Rodondi N, Kearney PMet al (2017) TRUST Study Group. Thyroid hormone therapy for older adults with subclinical hypothyroidism. N Engl J Med 376:2534–2544CrossRef Stott DJ, Rodondi N, Kearney PMet al (2017) TRUST Study Group. Thyroid hormone therapy for older adults with subclinical hypothyroidism. N Engl J Med 376:2534–2544CrossRef
22.
Zurück zum Zitat Surks MI, Hollowell JG (2007) Age-specific distribution of serumthyrotropin and antithyroid antibodies in the US population: implications for the prevalence of subclinical hypothyroidism. JClin EndocrinolMetab 92:4575–4582CrossRef Surks MI, Hollowell JG (2007) Age-specific distribution of serumthyrotropin and antithyroid antibodies in the US population: implications for the prevalence of subclinical hypothyroidism. JClin EndocrinolMetab 92:4575–4582CrossRef
23.
Zurück zum Zitat Taylor PN, Iqbal A, Minassian C et al (2014) Fallingthresholdfor treatmentofborderline elevated thyrotropin levels-balancing benefits and risks: evidence from a large community-based study. JAMAInternMed 174:32–39 Taylor PN, Iqbal A, Minassian C et al (2014) Fallingthresholdfor treatmentofborderline elevated thyrotropin levels-balancing benefits and risks: evidence from a large community-based study. JAMAInternMed 174:32–39
24.
Zurück zum Zitat Tunbridge WM, Evered DC, Hall R et al (1977) The spectrum of thyroid disease in a community: the Whickhamsurvey.ClinEndocrinol (Oxf)7:481–493CrossRef Tunbridge WM, Evered DC, Hall R et al (1977) The spectrum of thyroid disease in a community: the Whickhamsurvey.ClinEndocrinol (Oxf)7:481–493CrossRef
25.
Zurück zum Zitat Turner MR, Camacho X, Fischer HD et al (2011) Levothyroxine dose and risk of fractures in older adults:nestedcase-control study.BMJ 342:d2238CrossRef Turner MR, Camacho X, Fischer HD et al (2011) Levothyroxine dose and risk of fractures in older adults:nestedcase-control study.BMJ 342:d2238CrossRef
Metadaten
Titel
Ziele und Gefahren
Substitution mit Schilddrüsenhormonen: Seien Sie bei Älteren zurückhaltend
verfasst von
Dr. Alexander von Werder
Prof. Dr. Klaus von Werder
Publikationsdatum
31.05.2019
Verlag
Springer Medizin
Erschienen in
Geriatrie-Report / Ausgabe 2/2019
Print ISSN: 1862-5363
Elektronische ISSN: 2520-8950
DOI
https://doi.org/10.1007/s42090-019-0222-7

Weitere Artikel der Ausgabe 2/2019

Geriatrie-Report 2/2019 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.