A Study on Subclinical Hypothyroidism in Females Over 50 years of Age

Gopakumar, K S (2009) A Study on Subclinical Hypothyroidism in Females Over 50 years of Age. Masters thesis, Kilpauk Medical College, Chennai.


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INTRODUCTION: The term subclinical hypothyroidism was originally used to describe the patient with a low-normal free T4 but a slightly elevated serum TSH level. Other terms for this condition are mild hypothyroidism early thyroid failure, preclinical hypothyroidism, and decreased thyroid reserve. The TSH elevation in such patients is modest, with values typically between 4 and 15 mU/L, although patients with a TSH above 10 mU/L more often have a reduced free T4 and may have some hypothyroid symptoms. The definition of this syndrome depends significantly on the reference range for a normal TSH concentration. This syndrome is most often seen in patients with early Hashimoto's disease and is a common phenomenon, occurring in 7% to 10% of older women.1,2,3 Subclinical hypothyroidism may have endogenous causes (chronic autoimmune thyroiditis, subacute thyroiditis, postpartum thyroiditis) or exogenous causes (thyroidectomy, 131I therapy, antithyroid drugs, inadequate thyroid hormone replacement therapy). The prevalence of subclinical hypothyroidism is rather high. In the classical population-based study among adults in the English county of Whickham the prevalence was 75 per 1000 women and 28 per 1000 men1; similar figures have been obtained in other studies. The higher prevalence of subclinical hypothyroidism in females than in males and in older than in younger subjects is in agreement with the higher prevalence of thyroglobulin and thyroid peroxidase (microsomal) antibodies in women and in elderly people. AIM OF THE STUDY: 1. To estimate the prevalence of subclinical hypothyroidism among women above the age of 50 yrs. 2. To study the relationship of subclinical hypothyroidism to Hypertension, Diabetes and Ischemic Heart Disease in those patients. MATERIALS AND METHODS: Case selection: Women above the age of 50 years attending Medical out patient clinic of Kilpauk Medical College and Hospital, Chennai from January 2008 to June 2008 were studied. A sample of 100 women was randomly selected. Informed consent was obtained from all participants. All the participants were examined for thyroid function. Women with subclinical hypothyroidism (defined as TSH > 5.5μIU/ml with normal free T4 and free T3) were considered as cases, and women without subclinical hypothyroidism were considered as controls. Laboratory measurements and clinical assessment was carried out in all the participants. Exclusion criteria: Those with Known thyroid disease, History of neck irradiation, Chronic renal failure, Severe illness (such as infections , recent myocardial infarctions, severe heart failure or recent intensive care admission), Taking drugs such as beta-blockers, amiodarone, interferon –α were excluded. RESULTS: 100 women above the age of 50 years who visited the medical outpatient clinic during the study period were studied 23 women were found to have the criteria set for the definition of subclinical hypothyroidism which meant a rate of 23%. Patients with subclinical hypothyroidism were regarded as cases and remaining 77 patients were the control group. CONCLUSION: Subclinical hypothyroidism is highly prevalent in elderly women above the age of 50 years. • Most of those with subclinical hypothyroidism have TSH level below 10μIU/ml. • Hypothyroid symptoms are prevalent in patients with subclinical hypothyroidism. (30% of patients in this study) Fatigability and Constipation being the most common symptoms. • Patients with subclinical hypothyroidism are more prone to develop ischemic heart disease. • There is no increased risk for developing hypertension and diabetes mellitus in patients with subclinical hypothyroidism.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Subclinical Hypothyroidism ; Females ; Over 50 years of Age.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 11 Mar 2018 03:21
Last Modified: 11 Mar 2018 03:21
URI: http://repository-tnmgrmu.ac.in/id/eprint/6128

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