What are the characteristics of hyperthyroidism in the elderly? How to treat hyperthyroidism in the

Hyperthyroidism in the elderly is not uncommon, especially in recent years, it seems to be increasing, it may be that the improvement of medical conditions and the acceleration of the pace of life have increased the detection of hyperthyroidism in the elderly. However, hyperthyroidism in the elderly is often atypical and has the following characteristics:

1) A considerable number of elderly patients with hyperthyroidism are caused by toxic functional autonomic thermal nodules, such patients have a history of thyroid adenoma in the past, and the course of the disease is long, most of them have a course of 10 or 20 years, and the adenoma gradually grows, and the diameter of the adenoma is mostly greater than 4 5 cm.

2) The symptoms of hyperthyroidism in the elderly are often atypical, patients mostly complain of emaciation, palpitations are not obvious, some patients come to the clinic with simple emaciation to suspect malignant tumors, and the possibility of hyperthyroidism is considered only when the heart rate is increased during the physical examination.

3) Some patients have atrial fibrillation as the first symptom, and have been suffering from arteriosclerosis**, and only later found hyperthyroidism and delayed**. Most of the atrial fibrillation that occurs in patients with hyperthyroidism is atrial fibrillation with a rapid heart rate, while atrial fibrillation caused by arteriosclerosis is mostly atrial fibrillation with a normal heart rate, so the possibility of hyperthyroidism should be considered in the elderly who encounter rapid atrial fibrillation.

4) The goiter of elderly patients with hyperthyroidism is not obvious, and even the thyroid gland is not large when it is found during physical examination, and the murmur in the thyroid area is rarely heard.

5) There are fewer elderly patients with hyperthyroidism and hyperthyroidism.

6) The gastrointestinal symptoms of hyperthyroidism in the elderly are mostly manifested by loss of appetite, decreased eating and constipation, and there is a lack of hyperphagia, increased eating and diarrhea in young patients with hyperthyroidism.

7) The degree of elevated thyroid hormone in the laboratory examination of hyperthyroidism in the elderly is not as obvious as that in young patients with hyperthyroidism, especially because the serum thyroid hormone in normal elderly people is mildly reduced, especially T3

The decline was even more pronounced. Patients with toxic function autonomic thermal nodules present with serum T3

elevated, while t4

Normal, clinically known as T3

Hyperthyroidism. In the elderly with hyperthyroidism and systemic acute and chronic diseases, serum T3

May be normal while exhibiting t4

Elevated, known as T4

Hyperthyroidism. 8) It is better for elderly patients with hyperthyroidism to choose radioactive iodine**, the effect is relatively satisfactory, and it is also accepted by patients.

9) Elderly hyperthyroidism responds well to antithyroid drugs, and the dose should be small.

1) Significant emaciation: Some elderly patients will show outstanding emaciation, while other manifestations are not obvious. Moreover, such patients often show loss of appetite and are often suspected of gastrointestinal malignancy. to cause this symptom.

2) Apathy: Some elderly patients generally show apathy, and the patient's expression also becomes melancholy, tired, and depressed, which is generally completely different from that of younger patients.

3) Cardiac manifestations: Some elderly patients suddenly have arrhythmia, the more common is atrial fibrillation (electrocardiogram can be confirmed), and the general manifestation is paroxysmal or persistent atrial fibrillation, so it is often diagnosed as coronary heart disease.

4) Myopathy manifestations: Some elderly patients will have obvious muscle emaciation, especially the upper arm near the trunk and the patient's thigh muscles, so it is difficult for the patient to walk and lift objects.

Hyperthyroidism in the elderly generally refers to hyperthyroidism in people over 60 years old. It is not uncommon for the elderly to suffer from hyperthyroidism, the thyroid tissue of the elderly often has a certain degree of fibrosis and atrophy, the secretion of thyroid hormone is reduced, the degradation rate is slowed down, and the response of peripheral tissues to thyroid hormone is also changed, which causes the clinical manifestations of hyperthyroidism in the elderly to be atypical, easy to misdiagnose and miss the diagnosis.

Hello, if the elderly suffer from thyroid diseases such as hyperthyroidism, the first symptom of the patient's body is that the endocrine system begins to be disordered. In severe cases, it will affect the normal operation of other organs. Therefore, if the elderly have unexplained weight loss, then they must be alert to whether they have endocrine diseases such as hyperthyroidism.

Hyperthyroidism in the elderly is actually not uncommon, it is a secretory disease, the secretion of hormones in the patient's body has been disordered, when the elderly have hyperthyroidism, the patient should not be too afraid. Active treatment of hyperthyroidism in the elderly is very important, among which drug control, radioactive 131 iodine** and surgery** are the more commonly used** methods.

Patients with hyperthyroidism in the elderly will have symptoms such as not wanting to eat, nausea and vomiting, and will be more easily excited, easy to get angry and other symptoms, these symptoms are often mistaken for other types of diseases, so we must go to the hospital in time for examination and **, so how to hyperthyroidism in the elderly, below, let's take a specific look at it.

1. Drugs**.

Hyperthyroidism in the elderly can be carried out with antithyroid drugs**, when taking drugs, the condition of elderly patients can be effectively controlled. During the period of using the drug, the elderly patient must insist on taking the drug, not eating and stopping, and do not follow the doctor's instructions to use the medicine reasonably and safely.

If you stop taking the drug suddenly, it is easy to cause **, and the elderly patients who use the drug need to go to the hospital regularly to check their blood and liver function.

2. Radioactive 131 iodine**.

Older people with hyperthyroidism can use radioactive 131 iodine**, which can radiate radiation in the thyroid gland of older patients. This kind of radiation can destroy the thyroid follicular tissue of elderly patients, so that the synthesis of thyroxine can effectively reduce the effect of **.

Radioactive 131 iodine is a very suitable method for elderly patients who have cardiovascular complications and are unable to undergo surgery.

3. Surgery**.

For elderly patients who do not respond to drugs** and radioactive 131-iodine**, we can use surgery**. Surgery is to remove all the thyroid gland of elderly patients, so as to achieve the best effect.

Through surgery, the rate is very high, and it can effectively control the condition of elderly patients in a short period of time, which also has certain advantages. It should be noted that if the elderly patient has heart disease, or other more serious diseases, it is best to avoid surgery**.

In daily life, when the elderly suffer from hyperthyroidism, they can use the three methods introduced above to carry out **. In the usual diet, it is necessary to prohibit the intake of iodine, and eat more foods containing vitamin B, vitamin C, potassium, calcium, etc., which is also very helpful for the elderly with hyperthyroidism.

The elderly are also susceptible to this disease, and the harm to the elderly is relatively greater. Multiple organs in the body of older people may be damaged as a result. Here are the symptoms of hyperthyroidism in the elderly.

1. Cardiac abnormalities. After having hyperthyroidism, there is a high risk that older people will develop heart disease or abnormalities. Under the action of a large amount of thyroid hormones, the burden on the heart increases, leading to the deterioration of the condition, which can lead to atrial tachycardia, atrial fibrillation, tachycardia, angina, increased myocardial ischemia or even heart failure.

This is one of the clinical symptoms of hyperthyroidism in the elderly. According to statistics, among patients over 40 years old with hyperthyroidism, about 1 3 are accompanied by hyperthyroid heart disease, and 5% of elderly patients with hyperthyroidism are accompanied by atrial fibrillation. Usually only pay attention to the patient's cardiac symptoms, ignore the existence of hyperthyroidism, and delay**.

2. Digestive system. The digestive system of the elderly is not very perfect, and hyperthyroidism can affect the digestive system. Patients usually experience loss of appetite, anorexia, anorexia, diarrhea, constipation, or alternating diarrhea with constipation.

Some people think that this is related to the fact that the elderly often have chronic gastritis and lack of gastric acid. Due to less eating and more consumption, the general weight has decreased significantly, and some elderly patients with hyperthyroidism can lose 10-20 kg in a short period of time, and are often suspected of malignant tumors. This is also a clinical symptom of hyperthyroidism in the elderly.

Myopathy manifestations: Some elderly people with hyperthyroidism are characterized by obvious muscle wasting, especially the upper arm and thigh muscles close to the trunk, so it is difficult to walk and lift objects.

Significant wasting: Some elderly patients show significant emaciation, while others are not. Such patients often have loss of appetite and are often suspected of gastrointestinal malignancy. This is a distinctive feature of hyperthyroidism in older people.

Cardiac manifestations: some elderly patients have sudden onset of arrhythmias, the most common being atrial fibrillation (ECG can be confirmed), which manifests as paroxysmal or persistent atrial fibrillation, so coronary artery disease is often diagnosed. This is also a prominent manifestation of the characteristics of hyperthyroidism in the elderly.

Apathy: Some elderly patients show apathy, melancholy, fatigue and depression, which is completely different from that of younger patients.

Hyperthyroidism can lead to malignant complications such as proptosis, hand tremors, etc., which seriously affect life, in addition, it can also lead to different degrees of symptoms in various systems of the body

Systemic manifestations: dizziness, heat intolerance, hyperhidrosis, fatigue, weight loss;

Neuropsychiatric aspects: nervousness, irritability, emotional instability, anxiety, hyperactivity, distraction, insomnia;

cardiovascular system: palpitations, rapid heartbeat, irregular heartbeat, angina;

Digestive system: eat a lot but get hungry easily, have more frequent stools, diarrhea;

Muscles: wet, itchy, weak, painful, and even sudden inability to move the limbs (periodic paralysis);

Generally, it is common to have heat intolerance, sweating, and humidity, and it can also be caused by low-grade fever, easy hunger, excessive eating, and weight loss; Palpitation, increased heart rate, atrial fibrillation, cardiomegaly and heart failure in severe cases, increased systolic blood pressure, normal or low diastolic blood pressure, increased pulse pressure, increased intestinal peristalsis, often increased frequency of stool, diarrhea, easy to be excited, excited, many patients feel tired, weak, easy to fatigue, and many have muscle atrophy, often manifested in the muscles near the trunk of the limbs.

Quite a lot, according to the doctor's advice, understand your condition, symptomatic**.

Here are a few things to keep in mind when it comes to your diet:

1) Increase in calories**: Sufficient carbohydrates should be given daily to correct excessive consumption, and the daily energy supply is 12540 14630 kJ (3000 3500 kcal), which is 50 75 more than normal people, to meet the increase in metabolic rate caused by excessive thyroxine secretion.

2) Ensure protein supply: 15 grams of protein per kilogram of body weight** per day, but animal protein should be limited.

3) Pay attention to the supply of vitamins: it is advisable to supply a rich variety of vitamins, consume a large number of enzymes due to high metabolic energy consumption, and lack of a variety of water-soluble vitamins, especially B vitamins and vitamin D are the main vitamins to ensure the absorption of calcium and phosphorus, and should ensure the supply, while supplementing vitamin A and vitamin C.

Hyperthyroidism is a very scary disease, especially for the elderly. However, the symptoms of hyperthyroidism are sometimes not particularly obvious and can be easily misdiagnosed.

It is easy to be misdiagnosed as coronary heart disease, hypertension, heart failure, etc. But hyperthyroidism has its own characteristics:

1. Paroxysmal or transient atrial fibrillation, ventricular rate persisting at 100 beats to 120 beats, even at rest or sleep, no fever, no organic murmur on cardiac auscultation.

2. For any arrhythmia such as atrial fibrillation, premature contractions, supraventricular tachycardia, etc., the effect of antiarrhythmic drugs is not ideal.

3. Coronary heart disease has been systematically **, and angina pectoris, ischemic symptoms, and ST-segment changes on electrocardiogram are difficult to alleviate and disappear. When all of the above conditions occur, the possibility of hyperthyroidism should be considered.

The clinical manifestations of hyperthyroidism in the elderly are the opposite of typical hyperthyroidism, with the thyroid gland often not enlarged, and exophthalmosis is rare.

Many patients only present with apathy, confusion, unresponsiveness, melancholy, etc.

This is because the onset of hyperthyroidism in the elderly is insidious, the course of the disease is long, the patient is old and frail, and many other systems coexist, and each system is decompensated, so that the sympathetic nerve is in a state of inhibition. Patients are ineffective with antidepressants**, and sedatives are difficult to improve sleep.

Menopausal women are often misdiagnosed as menopausal syndrome due to irritability, insomnia, nervousness, nervousness, and easy agitation due to irritability, insomnia, nervousness, and irritability. However, the clinical features of the two are different: menopausal syndrome sweating is mostly characterized by paroxysmal hot flashes and sweating, and there is no weight loss; Sweating in patients with hyperthyroidism is characterized by excessive sweating in the palms of the hands, often accompanied by weight loss.

Diarrhea and emaciation are another prominent clinical manifestations of hyperthyroidism in the elderly. Hyperthyroidism and intractable diarrhea. Experimental studies have shown a positive correlation between episodes of diarrhea and thyroid hormone levels in the blood.

Due to the effects of thyroid hormones and catecholamines, the vagus nerve tone increases, the gastric emptying and intestinal peristalsis are accelerated, and the small intestine is malabsorbed, which is manifested as intractable diarrhea or increased stool frequency.

However, there is rarely abdominal pain, no tenesmus, loose and mushy stools, stool microscopy is often negative, colonoscopy is abnormal, and it is easy to misdiagnose chronic enteritis. Diarrhea and loss of appetite, the course of the disease is long and insidious, which can easily lead to water and electrolyte disorders, insufficient energy and various nutrients in the whole body, and obvious weight loss.

It is easy to be misdiagnosed as a malignant tumor of the digestive tract, or misdiagnosed as diabetes due to weight loss, polyphagia, and polyuria.

Shanghai Hongkang.