AGING AND THE THYROID - DECREASED REQUIREMENT FOR THYROID-HORMONE IN OLDER HYPOTHYROID PATIENTS
AGING AND THE THYROID - DECREASED REQUIREMENT FOR THYROID-HORMONE IN OLDER HYPOTHYROID PATIENTS
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DOI：
10.1016/0002-9343(83)91192-0
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发表时间：
1983-01-01
影响因子：
5.9
通讯作者：
KRAMER, SM
中科院分区：
文献类型：
--
作者：
SAWIN, CT;HERMAN, T;KRAMER, SM
在 84 名年龄 23-84 岁的原发性甲状腺功能减退患者中，将血清促甲状腺素水平降至正常范围所需的每日甲状腺素剂量，老年患者明显少于年轻患者（P < 0.01）。中年（40-60岁）和老年患者（60岁以上）之间的大部分差异是由于男性所需剂量的减少所致；这些年龄组的妇女所需的剂量没有差异。既往甲状腺功能亢进症并不影响所需的甲状腺素剂量；残留的自主甲状腺组织不太可能影响剂量。尽管所需剂量范围较大，无法使用这些数据来计算单个患者的甲状腺素剂量，但每天 100 μg 或更少的剂量在 40 岁以上的患者中很常见，少数 60 岁以上的患者需要每天 50 μg 或更少。使用低剂量甲状腺素（例如每天 25 μg）作为老年甲状腺功能减退患者的初始治疗的常见做法有良好的生理学基础，并且在老年患者中几年后重新评估甲状腺素的剂量可能是合理的。
In 84 patients, aged 23-84, with primary hypothyroidism, the daily dose of thyroxine needed to lower the serum thyrotropin level into the normal range was significantly less in older patients than in younger ones (P < 0.01). Most of the difference between middle-aged (40-60 yr) and older patients (greater than 60 yr) was due to a decrease in the required dose in men; there was no difference in the dose needed by women in these age groups. Previous hyperthyroidism did not affect the dose of thyroxine required; it is unlikely that residual autonomous thyroid tissue affected the dose. Although the wide range of doses needed precludes use of these data in calculating a dose of thyroxine for an individual patient, doses of 100 .mu.g per day or less were common in patients over age 40, and a few patients over age 60 needed 50 .mu.g per day or less. There is a sound physiologic basis for the common practice of using low doses of thyroxine, e.g., 25 .mu.g per day, as initial therapy in older hypothyroid patients and it may be reasonable to reassess the dose of thyroxine after several years in older patients.