Hypothyroidism affects a significant number of people over the age of 60, but symptoms are often mistaken for other conditions, so many other cases go undiagnosed. Robert Mair reports.

In this article:

  • What is hypothyroidism?
  • Symptoms
  • Diagnosis
  • Treatment

What is hypothyroidism?

Hypothyroidism occurs when the thyroid gland doesn’t make sufficient levels of the hormone thyroxine, which helps regulate the body’s metabolism. This causes the body to slow down – and is the opposite of hyperthyroidism, where the thyroid is overactive and the body’s functions speeds up.

An underactive thyroid can be linked to a variety of different common complaints and ailments, and is common in the over 60s. One in 500 women and 1 in 1,000 men will suffer from an underactive thyroid at some point and many more cases go undiagnosed due to the vagueness of symptoms in old age.


There are a number of symptoms for hypothyroidism, including:

  • Weight gain
  • Tiredness and lethargy
  • Depression
  • Feeling cold
  • Deep voice
  • Thinning hair
  • Dry, rough skin
  • Constipation
  • Aches and pains
  • Fluid retention

However, the only noticeable symptom in older people may be forgetfulness or memory loss – and this is often attributed to the ageing process, meaning hypothyroidism goes undetected.

Symptoms develop over several years and worsen over time. However, all of the symptoms of hypothyroidism can be caused by other conditions, so thyroxine levels could drop significantly before a successful diagnosis is made.

If left untreated for an extended period of time, hypothyroidism could lead to:

  • Goitre. A swelling of the thyroid
  • Heart disease
  • Hypothyroid or myxoedema coma. This is a potentially fatal – although rare – complication, which is essentially an extreme version of hypothyroidism and can result in death. It is often brought on by hypothermia.
  • Mental health problems
  • Infertility

However, the prognosis for people with hypothyroidism is excellent if treatment is sought.


If you experience some or all of the symptoms above, you will need to see your GP. Hypothyroidism is usually diagnosed by a blood test. This will measure the levels of thyroid stimulating hormone (TSH) which is produced in the pituitary gland. If the pituitary gland is releasing too much TSH, it means the thyroid gland is underactive and requires extra stimulation. Thyroxine levels will also be checked, and if this is low it will confirm a diagnosis of hypothyroidism.

If TSH levels are high and thyroxine levels are normal, it means the thyroid gland needs more stimulation to produce thyroxine. Subsequent blood tests are required every 3 or 4 months to check these levels, as people in this situation are prone to developing hypothyroidism.

Usually a blood test will suffice in diagnosing hypothyroidism, but if levels of thyroxine and TSH are low, additional tests may be carried out on the pituitary gland.


An underactive thyroid is usually not serious. A life-long course of tablets that supplement thyroxine levels is the typical treatment for hypothyroidism because it is rare for the disease to reverse itself.

In order to find the right strength tablet, changes will be made to the prescription over a period of time to test which produces the best response. It may also have to be adjusted if thyroxine levels or TSH levels change.