Treatment of Older Adults With Subclinical Hypothyroidism —Reply

In Reply The population distribution of thyrotropin across the human life span has been reported in multiple studies with ambiguous results: both increase and decrease with increasing age have been reported. These inconsistencies may reflect differences in iodine intake across cohorts or age categories and underscore that population distributions alone are unfit to determine reference ranges. Other observational studies of subclinical hypothyroidism, including the NHANES study mentioned by Dr Hershman as well as an individual patient data meta-analysis by Rodondi et al, showed no association of subclinical hypothyroidism with mortality and cardiovascular events in individuals aged 80 years and older. However, because these data have all been observational, they are not suitable to definitely establish or rule out causality. Therefore, until now, existing studies have not justified age-specific reference ranges and guidelines currently do not support them.
Source: JAMA - Category: General Medicine Source Type: research