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.
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.
To learn more about diseases and conditions of the thyroid, read the Special Health Report, Thyroid Disease from Harvard Medical School.
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