Age v levels

[MitziMax]

I am not sure but are levels not linked to your age I am 65 and wondering if my levels would be different than a 30 year old .

[shaws Administrator]

I don't think (and am not medically qualified) that age is a factor in our prescriptions. The aim is to relieve all clinical symptoms so doses vary.

[MitziMax in reply to shaws]

d

[MitziMax in reply to shaws]

Found this

TSH levels in women

Here’s a breakdown of normal, low, and high TSH levels for women based on age:

Age rangeNormalLowHigh

18 – 29 years0.4 – 2.34 mU/L< 0.4 mU/L> 4.5 mU/L

30 – 49 years0.4 – 4.0 mU/L< 0.4 mU/L> 4.1 mU/L

50 – 79 years0.46 – 4.68 mU/L< 0.46 mU/L4.7 – 7.0 mU/L

[shaws Administrator in reply to MitziMax]

Thank you.

[MitziMax in reply to shaws]

[MaisieGray in reply to MitziMax]

Assuming that those reference ranges are statistically correct, they indicate clearly that as we age, we function differently - less efficiently or effectively. So the debate then, is whether we treat thyroid disfunction to those age-specific ranges so that we return it to an age-dependent homeostasis; or do we aim to make the thyroid function "as good as new" and treat to the standard reference range whilst the other parts of us are functioning in an age-related way, such that the homeostasis is upset? People are intervening in their bodies' natural functioning & ageing processes, in all manner of ad hoc ways in their fight to stay young, so should thyroid treatment be any different? Or is is adding to problems in the long term? Mmmm.

[MaisieGray]

From a review article by Gateshead NHS Trust 2013:

"Serum TSH, free T4, and free T3 concentrations change with aging. The first Whickham survey, published in 1977, showed that TSH levels did not vary with age in males but increased markedly in females after the age of 45 years. The rise of TSH with age in females was virtually abolished when persons with thyroid antibodies were excluded from the sample. However, in this landmark study, the number of individuals aged 75 or more was quite small, thus limiting the ability to detect a significant increase in TSH in this age group. The 20-year follow-up Whickham survey showed that with increasing age, the incidence of positive antithyroid antibodies and hypothyroidism also increased. This follow-up study, though, was unable to assess longitudinal change in serum TSH and thyroid hormones as more sensitive assays had been utilized, thus making any meaningful comparisons difficult. The larger and more recent NHANESIII survey showed that serum TSH concentrations as well as serum thyroid peroxidase (TPOAb) and thyroglobulin (TgAb) antibodies rise with age in both men and women. In this study, the median TSH increased and T4 decreased after age 20 in all ethnic groups, even after excluding thyroid antibody status and other risk factors. In a subsequent further analysis, Surks and Hollowell examined the NHANESIII data which showed a progressive increase in mean, median, and 97.5 centile for TSH concentration with age in the disease-free and reference populations. This analysis suggested that the 97.5 centile is about 3.6 mIU/litre in people who are 20–39 yr of age and 5.9 and 7.5 mIU/litre in those who are 70–79 and 80 yr old and older, respectively. They also demonstrated that about 70% of older patients who would be classified as subclinical hypothyroidism with TSH greater than 4.5 mIU/litre were within their age-specific reference range. Consequently, the authors have suggested that age-based reference ranges for TSH should be considered.

Moreover, a recent longitudinal study from Western Australia (Busselton survey), for the first time, showed that serum TSH increases (mean increase of 0.32 mU/L over 13 years) with no significant change in free T4 concentrations with aging. Similarly, another longitudinal thyroid function evaluation in a very elderly subgroup (mean age 85 years) of the Cardiovascular Health Study (All Stars Study) found that serum TSH increased by 13% over an average of 13 years of follow-up associated with a 1.7% increase in FT4 and a 13% reduction in total T3 levels."

[greygoose]

I think the short answer is: they may be in healthy people, but in hypos age is irrelevant, and doctors should not be comparing us to healthy people at any age. Hypo's need what they need, regardless of their age.

[shaws Administrator in reply to greygoose]

I agree, especially if doctors in the UK stick to the 'rules' of not diagnosing until TSH is 10.

If the medical profession disregard or don't test the correct hormone levels in the elderly there will be even more undiagnosed and untreated people.

[MaisieGray in reply to shaws]

I wonder in practice, how many/few Drs actually do adhere to a TSH of 10 cut off, in the presence of symptoms? The guidance to them in the NICE Clinical Knowledge Summaries is that if the TSH is between 4 and 10 mU/L and FT4 is within the normal range, in people aged less than 65 years with symptoms suggestive of hypothyroidism, the Dr should consider a trial of LT4 and assess response to treatment 3–4 months after TSH stabilises within the reference range. Certainly people often report here that they've just been diagnosed and state their TSH result as something less than 10; and so clearly not treating until 10, is not universally adopted by all GPs.

[shaws Administrator in reply to MaisieGray]

I wasn't diagnosed (despite consulting many doctors and specialists and even having an op on my throat (to remove something! which wasn't there). What was on the barium swallow I asked and got no response.

Not one doctor ever tested my thyroid hormones and one, because I had threatened to get a whole body scan privately as I said I was so very ill and felt there was something seriously wrong with me (months after feeling very unwell and with a stomach that had swollen), reassured me and said I may be misled. He would do a thorough check.

He phoned and reassured me that all my results were fine (tested 23 possibilities). I cried. Fortunately at an airport two days previously a First Aider mentioned 'thyroid' and I had phoned surgery and demanded a blood test form be left for me, at 8 a.m. next day I got test and an hour later another doctor phoned me and said, come and get a prescription you have hypothyroidism and 'who requested a blood test form' I said I did. I had no knowledge of this condition and knew no-on who had.

When going through the original bundle of tests only the other day, the first doctor had missed a TSH of 95.5 when he told me there was nothing wrong and all tests were fine.

The more we read the more we realise how poorly trained doctors are with regard to anything to do with the thyroid gland. The skill they had when diagnosing by symptoms alone and giving a trial of NDT has gone and so many remain very unwell besides being diagnosed and given levo and TSH kept 'in range' instead of 1 or lower.

[MaisieGray in reply to shaws]

Undoubtedly there are occasions when Drs miss, or misinterpret blood test results even though you'd think is was easy enough to grasp that if a value is outside a range, it can't be right; and equally that some don't make the connection between symptoms and disease. But those are different issues from your earlier point of Drs intentionally "not diagnosing until the TSH is 10", to which I was responding. At worst, some Drs may be disregarding the CKS guidance but from patient first hand reports it's clearly not true of all, and not representative of the guidance to them.

[shaws Administrator in reply to MaisieGray]

Quite a number of patients on the forum remain undiagnosed even when TSH is around 5.

[humanbean in reply to MaisieGray]

The NHS is, effectively, breaking up into little pieces as far as I can tell. GPs are now following the guidelines produced by their CCG.

I suppose if the CCG hasn't made a pronouncement on a particular thing then national guidelines would be used.

[GKeith in reply to greygoose]

Another view could be, however, god forbid, that there are so many elderly people who have never been correctly diagnosed as hypo. I know so many, just close relatives, that have symptoms and I can't even get them to get tested, their understanding of the thyroid and the many offshoot problems it can cause is not really mystifying to me however, because for 27 years I took one little pill, Levo, barely even aware of the pill or it's meaning. It is only when we "crash" or become so sick that we can no longer stand it that we "educate" ourselves, most, out of self-defense and the absolute ignorance of so many physicians, esp. endo's, is something I truly believe is criminal, and, at the very least, a serious danger to the mental health of the humans living on this planet. I realize that most people in the medical field have very few, if any, religious beliefs but, even that, should not be a barrier between them and their patients, even more so it shouldn't: they should want to please them, as they have no belief's, or hope, of getting "praise" from anywhere else.

[greygoose in reply to GKeith]

Most doctors despise their patients, that's the barrier.

[GKeith in reply to greygoose]

I know and it makes absolutely no sense to anyone but those certain few, or many, doctors that consider themselves an elite part of the population. It happens also to many others in high-profile occupations, like lawyers, actors and politicians not to mention anyone with enough wealth to live in a world of "make believe." Sad, very, very sad. It is a conundrum I have never been able to solve.

[greygoose in reply to GKeith]

Me, neither. But there have always been the 'haves' and the 'have nots'. Seems to be human nature.

[GKeith in reply to greygoose]

Too many have not's as compared to the very few have too much's. I've met both sides and have always liked the have not's much better. I happen to believe that the most admirable thing a man, or woman, can do, who happens to find themselves in a position of great wealth is too not only give it all away but to become poor (upper middle-class to the really poor) themselves. I know of very few but I do know that one of the Rockefeller's was quoted as saying: "I know of nothing more despicable and pathetic than a man who devotes all the hours of the waking day to the making of money for money's sake." I forget which Rockefeller it was. Of course, the poorest 'man' who ever lived was Jesus Christ.

[greygoose in reply to GKeith]

Money is a drug. The more some people have, the more they want. There's not much we can do about it.

[GKeith in reply to greygoose]

The price we pay for money is usually too much - our liberty. Does the man rule the money or does the money rule the man? The love of humanity and the love of money seldom meet.

[Angel_of_the_North]

Many older people have higher TSH as their thyroids "wear out" like everything else and they are struggling to make enough thyroid hormone. They often have higher blood pressure and arthritis too. That doesn't mean it a good thing. Lies, damn lies and statistics.

[MaisieGray in reply to Angel_of_the_North]

Why is lying, and what about?

[Angel_of_the_North in reply to MaisieGray]

It's a famous quotation, saying that you can't believe statistics as they are written without a lot more knowledge and investigation. en.wikipedia.org/wiki/Lies,... and york.ac.uk/depts/maths/hist...

[humanbean]

If you want more info on TSH and age, see this thread :

healthunlocked.com/thyroidu...