Over the years we have seen quite a number of claims that old people often have lower thyroid hormone levels and higher TSH - but no evidence that treating is worthwhile. Alongside suggestions that so-called subclinical hypothyroidism in the older population might actually improve longevity. (Quality of life, as so often, mostly the unmentioned elephant in the room.)
So rather good to see a paper in which treating is shown to result in lower mortality. Also, in line with the feelings and beliefs of many posters even if they do not have adequate data to back it up to medics.
J Clin Endocrinol Metab. 2018 Jun 26. doi: 10.1210/jc.2018-00408. [Epub ahead of print]
Association of Hypothyroidism with All-cause Mortality: A Cohort Study in an Older Adult Population.
Huang HK1, Wang JH2, Kao SL1.
1 Department of Family Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
2 Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
Although hypothyroidism is associated with many comorbidities, the evidence for its association with all-cause mortality in older adults is limited.
To evaluate the association between hypothyroidism and all-cause mortality in older adults.
Population-based retrospective cohort study.
National Health Insurance Research Database in Taiwan.
After 1:10 age/sex/index year matching, 2029 patients aged ≥65 years who received a new diagnosis of hypothyroidism between 2001 and 2011, and 20290 patients without hypothyroidism or other thyroid diseases, were included in the hypothyroidism and non-hypothyroidism cohorts respectively.
Main Outcome Measures:
All-cause mortality was defined as the primary outcome. Cox proportional hazards regression models were used to calculate the hazard ratios (HRs) of mortality. To further evaluate the effect of thyroxine replacement therapy (TRT) on mortality, we divided patients with hypothyroidism into two groups: patients who received TRT and those who did not.
Hypothyroidism was associated with an increased risk of all-cause mortality (adjusted HR [aHR] = 1.82, 95% confidence interval [CI] = 1.68-1.98, p < 0.001). Patients with hypothyroidism who received TRT had a lower risk of mortality than patients who did not receive TRT (aHR = 0.57, 95% CI = 0.49-0.66, p < 0.001). Similar results were obtained after further propensity score matching, in age-, sex-, and comorbidity-stratified analyses.
Hypothyroidism was independently associated with increased all-cause mortality in older adults. In patients with hypothyroidism, TRT was associated with a lower risk of all-cause mortality.
Afraid full paper does not seem (yet?) to be available.