This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (209)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Thyroid Deficiency in the Framingham Study

Clark T. Sawin, MD; William P. Castelli, MD; Jerome M. Hershman, MD; Patricia McNamara; Pamela Bacharach

Arch Intern Med. 1985;145(8):1386-1388.

Abstract
• In an unselected population of elderly (over age 60 years) men and women (the original cohort of the Framingham Study), the prevalence of thyroid deficiency, evidenced by a clearly elevated serum thyrotropin (TSH) level (>10 µU/mL), was 4.4%. Women had thyroid deficiency (5.9%) more often than men (2.3%). Of those with clearly elevated serum TSH levels, only 39% had low serum thyroxine (T₄) levels; the remainder had serum T₄ levels in the lower half of the normal range. Others (5.9%) had a slightly elevated serum TSH level (5 to 10 µU/mL); their status was not clear, but more (12.7%) had low T₄ levels than expected. The level of serum T₄ was not a sensitive measure of thyroid deficiency nor was routine examination by a physician, even when the patient's background contained a clue to a possible thyroid problem. An elevated serum TSH level was a sensitive marker of thyroid deficiency in the elderly and was often the only way to detect it. Further studies are needed to determine the relationship of thyroid deficiency to cognitive and cardiovascular function in older persons.

(Arch Intern Med 1985;145:1386-1388)

Author Affiliations
From the Medical Service, Boston Veterans Administration Medical Center (Dr Sawin and Ms Bacharach); the Framingham Heart Study, National Heart, Lung, and Blood Institute, Framingham, Mass (Dr Castelli and Ms McNamara); the Medical Service, Wadsworth Veterans Administration Medical Center, Framingham, Mass (Dr Hershman); and the Departments of Medicine, Tufts University School of Medicine, Boston (Dr Sawin); and UCLA School of Medicine, Los Angeles (Dr Hershman).

Footnotes
Accepted for publication Nov 26, 1984.

Reprint requests to Veterans Administration Medical Center, 150 S Huntington Ave, Boston, MA 02130 (Dr Sawin).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Sleep, Sleep Disorders, and the Endocrine System
Vorona
ACCP Sleep Med Brd Rev 2009;4:163-184.
FULL TEXT  

Meta-analysis: Subclinical Thyroid Dysfunction and the Risk for Coronary Heart Disease and Mortality
Ochs et al.
ANN INTERN MED 2008;148:832-845.
ABSTRACT | FULL TEXT  

Thyroid Function and Lipid Subparticle Sizes in Patients with Short-Term Hypothyroidism and a Population-Based Cohort
Pearce et al.
J. Clin. Endocrinol. Metab. 2008;93:888-894.
ABSTRACT | FULL TEXT  

The Clinical Significance of Subclinical Thyroid Dysfunction
Biondi and Cooper
Endocr. Rev. 2008;29:76-131.
ABSTRACT | FULL TEXT  

Prevalence of Subclinical Thyroid Dysfunction and Its Relation to Socioeconomic Deprivation in the Elderly: A Community-Based Cross-Sectional Survey
Wilson et al.
J. Clin. Endocrinol. Metab. 2006;91:4809-4816.
ABSTRACT | FULL TEXT  

Thyroid Function and Prevalence of Anti-Thyroperoxidase Antibodies in a Population with Borderline Sufficient Iodine Intake: Influences of Age and Sex
Hoogendoorn et al.
Clin. Chem. 2006;52:104-111.
ABSTRACT | FULL TEXT  

Aggregation of High-Normal Thyroid-Stimulating Hormone in Hypertensive Families
Gumieniak et al.
J. Clin. Endocrinol. Metab. 2005;90:5985-5990.
ABSTRACT | FULL TEXT  

Goiter in Adult Patients Aged 55 Years and Older: Etiology and Clinical Features in 634 Patients
Diez
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2005;60:920-923.
ABSTRACT | FULL TEXT  

Risk for Ischemic Heart Disease and All-Cause Mortality in Subclinical Hypothyroidism
Imaizumi et al.
J. Clin. Endocrinol. Metab. 2004;89:3365-3370.
ABSTRACT | FULL TEXT  

Subclinical Hypothyroidism and the Risk of Hypercholesterolemia
Hueston and Pearson
Ann Fam Med 2004;2:351-355.
ABSTRACT | FULL TEXT  

Prevalence of Thyroid Dysfunction in Patients With Meniere's Disease
Brenner et al.
Arch Otolaryngol Head Neck Surg 2004;130:226-228.
ABSTRACT | FULL TEXT  

Subclinical Thyroid Disease: Scientific Review and Guidelines for Diagnosis and Management
Surks et al.
JAMA 2004;291:228-238.
ABSTRACT | FULL TEXT  

Subclinical Thyroid Disease: Clinical Applications
Col et al.
JAMA 2004;291:239-243.
ABSTRACT | FULL TEXT  

Searching for the Autoimmune Thyroid Disease Susceptibility Genes: From Gene Mapping to Gene Function
Tomer and Davies
Endocr. Rev. 2003;24:694-717.
ABSTRACT | FULL TEXT  

Effects of Subclinical Hypothyroidism and its Treatment on Serum Lipids
Ineck and Ng
The Annals of Pharmacotherapy 2003;37:725-730.
ABSTRACT | FULL TEXT  

Effects of Subclinical Thyroid Dysfunction on the Heart
Biondi et al.
ANN INTERN MED 2002;137:904-914.
ABSTRACT | FULL TEXT  

Prospective Study of the Spontaneous Course of Subclinical Hypothyroidism: Prognostic Value of Thyrotropin, Thyroid Reserve, and Thyroid Antibodies
Huber et al.
J. Clin. Endocrinol. Metab. 2002;87:3221-3226.
ABSTRACT | FULL TEXT  

Hypothyroidism in Patients Older Than 55 Years: An Analysis of the Etiology and Assessment of the Effectiveness of Therapy
Diez
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2002;57:M315-320.
ABSTRACT | FULL TEXT  

Lipoprotein Profile in Subclinical Hypothyroidism: Response to Levothyroxine Replacement, a Randomized Placebo-Controlled Study
Caraccio et al.
J. Clin. Endocrinol. Metab. 2002;87:1533-1538.
ABSTRACT | FULL TEXT  

The Treatment of Subclinical Hypothyroidism Is Seldom Necessary
Chu and Crapo
J. Clin. Endocrinol. Metab. 2001;86:4591-4599.
FULL TEXT  

The Relationship between Thyrotropin and Low Density Lipoprotein Cholesterol Is Modified by Insulin Sensitivity in Healthy Euthyroid Subjects
Bakker et al.
J. Clin. Endocrinol. Metab. 2001;86:1206-1211.
ABSTRACT | FULL TEXT  

Effect of Thyroxine Therapy on Serum Lipoproteins in Patients with Mild Thyroid Failure: A Quantitative Review of the Literature
Danese et al.
J. Clin. Endocrinol. Metab. 2000;85:2993-3001.
ABSTRACT | FULL TEXT  

American Thyroid Association Guidelines for Detection of Thyroid Dysfunction
Ladenson et al.
Arch Intern Med 2000;160:1573-1575.
ABSTRACT | FULL TEXT  

The Colorado Thyroid Disease Prevalence Study
Canaris et al.
Arch Intern Med 2000;160:526-534.
ABSTRACT | FULL TEXT  

Subclinical Hypothyroidism Is an Independent Risk Factor for Atherosclerosis and Myocardial Infarction in Elderly Women: The Rotterdam Study
Hak et al.
ANN INTERN MED 2000;132:270-278.
ABSTRACT | FULL TEXT  

Urinary iodine concentrations and thyroid function in adult Zimbabweans during a period of transition in iodine status
Gomo et al.
Am. J. Clin. Nutr. 1999;70:888-891.
ABSTRACT | FULL TEXT  

Diagnosis of Thyroid Disease in Hospitalized Patients: A Systematic Review
Attia et al.
Arch Intern Med 1999;159:658-665.
ABSTRACT | FULL TEXT  

Hashimoto's Thyroiditis and Insulin-Dependent Diabetes Mellitus: Differences among Individuals with and without Abnormal Thyroid Function
McCanlies et al.
J. Clin. Endocrinol. Metab. 1998;83:1548-1551.
ABSTRACT | FULL TEXT  

Iodine Intake and the Pattern of Thyroid Disorders: A Comparative Epidemiological Study of Thyroid Abnormalities in the Elderly in Iceland and in Jutland, Denmark
Laurberg et al.
J. Clin. Endocrinol. Metab. 1998;83:765-769.
ABSTRACT | FULL TEXT  

Managing subclinical hypothyroidism
DTB 1998;36:1-3.
ABSTRACT | FULL TEXT  

Subclinical Thyroid Dysfunction
Woeber
Arch Intern Med 1997;157:1065-1068.
ABSTRACT  

Should Physicians Screen for Mild Thyroid Failure?-Reply
Danese et al.
JAMA 1996;276:1550-1551.
ABSTRACT  

Screening for Mild Thyroid Failure at the Periodic Health Examination: A Decision and Cost-effectiveness Analysis
Danese et al.
JAMA 1996;276:285-292.
ABSTRACT  

Chronic Autoimmune Thyroiditis
Dayan and Daniels
NEJM 1996;335:99-107.
FULL TEXT  

Impaired Action of Thyroid Hormone Associated with Smoking in Women with Hypothyroidism
Muller et al.
NEJM 1995;333:964-969.
ABSTRACT | FULL TEXT  

Hyperthyroidism as a Cause of Atrial Fibrillation in Long-term Care
Siebers et al.
Arch Intern Med 1992;152:2063-2064.
ABSTRACT  

Thyroid Dysfunction in Elderly Hospitalized Patients: Effect of Age and Severity of Illness
Simons et al.
Arch Intern Med 1990;150:1249-1253.
ABSTRACT  

Screening for Thyroid Disease
Helfand and Crapo
ANN INTERN MED 1990;112:840-849.
ABSTRACT  

Thyroid Dysfunction in Adults Over Age 55 Years: A Study in an Urban US Community
Bagchi et al.
Arch Intern Med 1990;150:785-787.
ABSTRACT  

The Aging Thyroid: The Use of Thyroid Hormone in Older Persons
Sawin et al.
JAMA 1989;261:2653-2655.
ABSTRACT  

Yield of Hypothyroidism in Symptomatic Primary Care Patients
Schectman et al.
Arch Intern Med 1989;149:861-864.
ABSTRACT  

Screening for Hypothyroidism in the Elderly
Rosen
Arch Intern Med 1986;146:201-201.
ABSTRACT