Diagnostic concepts like "subclinical hypothyroidism" have become cognitive barriers to understanding the adaptations and dysfunctions of the aging hypothalamus-pituitary-thyroid (HPT) axis. Thyroid diagnostic categories are usually based on whether TSH and FT4 are in range, above range, or below range, in relation to an age-blind reference range. These are convenient biochemical stereotypes. These stereotypes have … Continue reading Four types of unstable thyroid function in the elderly
No one wants to be ageist or sexist in thyroid screening or diagnosis. But if we are blind to the way that age and sex can distort the hypothalamus-pituitary-thyroid (HPT) axis, our interpretations of thyroid hormone levels and TSH will inevitably become ageist and sexist by refusing to respect and accommodate human diversity. In a … Continue reading Age, sex and TSH-FT4-FT3 relationships: Advanced lessons
Scientists have been explaining that TSH responds to thyroid hormones differently in childhood, early adulthood, late adulthood and very advanced age. This poses a problem for regions that have implemented TSH-only screening for thyroid dysfunction. The effect of age on TSH is one of many factors that can make this screening test less accurate (Ling … Continue reading Age bias may hide hypothyroidism under a normal TSH
