Mechanistic Study of Subclinical Hypothyroidism In the Elderly

Launched by UNIVERSITY OF PENNSYLVANIA · Mar 20, 2015

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Eligibility criteria

• Inclusion Criteria:
• • 1. men and women aged 70 and older
• • 2. TSH between 4.5 and 19.9 mU/L as an outpatient
• • 3. ability to provide informed consent
• Exclusion Criteria:
• Laboratory Tests:
• • 1. TSH \<4.5 mU/L or \>20 mU/L on repeat testing at least four weeks later or free T4 level outside the reference range
• • 2. thyroid peroxidase (TPO) antibody positive
• • 3. abnormal liver function tests (LFTs \>3 x upper limit of normal)
• • 4. hemoglobin \<11 g/dL
• Surgeries or Procedures:
• • 1. thyroid surgery
• • 2. pituitary surgery
• • 3. bariatric surgery
• • 4. bowel resection involving the jejunum and upper ileum
• • 5. radioactive iodine therapy
• • 6. radiation treatments to head or neck
• Medical Conditions:
• • 1. diagnosis of pituitary disease
• • 2. diagnosis of amyloidosis, sarcoidosis, hemochromatosis
• • 3. diagnosis of adrenal insufficiency
• • 4. obesity with BMI \> 35 mg/kg2
• • 5. history of stroke
• • 6. chronic or ongoing angina, Class II or higher congestive heart failure, or uncontrolled hypertension with current blood pressure greater than 160/100
• • 7. diabetes mellitus with hemoglobin A1C level greater than 8.0% in the past six months
• • 8. celiac sprue, Crohn's disease, ulcerative colitis, Zollinger-Ellison syndrome
• • 9. renal insufficiency with calculated glomerular filtration rate \<45 cc/min
• • 10. cognitive impairment with Mini Mental State Exam\[30\] \<24/30
• • 11. history of any seizures
• • 12. unstable medical or psychological condition in the judgment of the principal investigator
• Medications:
• • 1. thyroid hormone preparations
• • 2. antithyroid drugs
• • 3. medications that interfere with the absorption or metabolism of thyroid hormone
• • 4. medications that interfere with the TRH stimulation test
• • 5. proton pump inhibitors