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Question:

I am 77 years old and my thyrotropin levels are 0.08 µU/mL

Are they abnormal?

What is at risk?

Abbey

Answer:

Dear Abbey,

Low or undetectable levels of TSH are present in patients with hyperthyroidism.

Each laboratory defines its own normal ranges but using the SimulTRAC FT4/TSH Solid Phase Component System, Hyperthyroid Ranges for

TSH: 0.05 - 0.56 µU/mL

Commonest cause of reduced (<0.1 mU/L) Thyrotropin and normal FT4 or FT3 is taking thyroxine. Less commonly, is sub clinical primary hyperthyroidism (elderly). Often a multinodular goiter is present.

An abnormal thyrotropin result will necessitate additional tests - probably FT4 or FT3 estimates, in the first instance. More sophisticated investigations (e.g. anti-TPO, radioiodine uptake) may be ordered by a thyroid-specializing endocrinologist.

Low and high thyrotropin levels were associated with an increased risk of incident Alzheimer's disease in women but not in men.

Researchers found that women with the lowest (less than one milli-international unit per liter) and highest (more than 2.1 milli-international units per liter) levels of thyrotropin had more than a twofold increased risk of Alzheimer's.

Thyrotropin is known also as thyroid stimulating hormone (TSH). Thyrotropin (or, if you prefer, TSH) promotes the growth of the thyroid gland in the neck.

35 85-year-old men and women who were found to have low thyrotropin levels were followed for three years. Eighteen were not receiving thyroid hormone treatment, and no cause could be found for their low thyrotropin levels. They did not suffer from hyperthyroidism, in which excess levels of thyroid hormones inhibit the production of thyrotropin

Low thyrotropin levels in the elderly are not necessarily a sign of hyperthyroidism or impending death. Better diagnostic tests will help to identify elders who are truly hyperthyroid.

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