Actualización en el manejo del hipotiroidismo en el adulto mayor

Abstract

Background: Hypothyroidism is a disease characterized by insufficient thyroid hormone production. It can increase morbidity and mortality due to multiple organ failure, with a prevalence of 5.9% among adults over 65. Objective: To determine the latest upgrade in hypothyroidism management in older people. Methodology: A narrative scientific literature review was conducted using scientific articles published during the last five years, in English and Spanish, related to the management update in older adults’ hypothyroidism; thus, the databases Scopus, PubMed, ProQuest, Medline, SciFinder, and SciELO were consulted. The bibliographic descriptors DeCs/MeSh were applied as a search strategy, with keywords in Spanish and English: comorbidities, diagnosis, aging, hypothyroidism, symptoms, treatment, and their combinations; in addition, Boolean operators "AND," "OR," and "NOT" were used in search of the articles; finally, the articles were classified according to the inclusion and exclusion criteria. A total of 140 were selected, of which 73 were excluded after analyzing their abstracts. Sixty-seven papers were reviewed, discarding duplicates, from which 37 documents were selected for the present literature review. Results: Hypothyroidism is a common disease in postmenopausal women, and the prevalence ranges from 0.9 to 5.9% among older adults. Its symptoms are variable among individuals, and it might be oligosymptomatic. Its diagnosis is made by the signs and symptoms of the disease. Still, it must be confirmed in the laboratory by measuring Thyroid Stimulating Hormone (TSH) levels. Levothyroxine remains the drug of choice. However, it should be used at low doses and under monitoring to avoid cardiovascular and cognitive alterations that increase morbidity and mortality.