Shakaib U. Rehman, MD, Primary Care Service Line, Ralph H. Johnson V.A. Medical Center; Department of Medicine, Medical University of South Carolina, Charleston, SC, USA.
Jan N. Basile, MD, Director, Primary Care Service Line, Ralph H. Johnson VA Medical Center; Professor of Medicine, Medical University of South Carolina, Charleston, SC, USA.
Florence N. Hutchison, MD, Chief of Staff, Ralph H. Johnson V.A. Medical Center; Department of Medicine, Medical University of South Carolina, Charleston, SC, USA.
Older patients with hyperthyroidism present with atypical symptoms such as difficulty concentrating. This is in contrast to younger patients, who present with classic symptoms such as heat intolerance, tremor, and tachycardia. Hyperthyroidism in older adults is most often caused by toxic multinodular goiter and Graves’ disease. Thyroid hormones and thyroid-stimulating hormone assays can establish the diagnosis quickly. Antithyroid medication can be used in medically unstable older hyperthyroid patients to quickly suppress the hormones. When the patient is stable, definitive therapies such as radioactive iodine or surgery should be considered. Radioactive iodine therapy is well tolerated and effective. Surgery is indicated in patients who fail to respond to radioactive iodine therapy and patients with multinodular goiter.
Key words: thyrotoxicosis, older adults, hyperthyroidism, Graves’ disease, T3 toxicosis.
