Do you have memory loss…fatigue…weight gain…constipation? If you’re in your 60s or older, your doctor might dismiss these symptoms as normal aspects of aging. But they could be caused by a very treatable condition that doctors often miss in older people.

These symptoms can be a result of trouble with the thyroid gland—specifically, hypothyroidism, in which the thyroid gland doesn’t produce enough thyroid hormone. Typically, when a blood test shows a thyroid-stimulating hormone (TSH) level around 4.0 milli-international units per liter (mlU/L), it suggests hypothyroidism—but after age 60 or so, you can have a TSH level well above 4 even with a healthy thyroid.

Your doctor might think you have ­hypothyroidism and prescribe hormone treatment when you don’t have it. And that’s just as bad as missing it.

What to do: If your doctor dismisses your symptoms as normal aspects of aging, ask whether he/she has considered hypothyroidism—especially if your symptoms developed relatively rapidly.

If your doctor conducts a TSH blood test and then prescribes synthetic thyroid hormone, ask, “What’s my TSH level?” If it is above 10, treatment is almost certainly justified. But if it is between 4 and 10 and you are past age 60, ask…

“Are we sure that my TSH level is above range for my age?” Your doctor’s response should indicate that he understands that older people can have healthy thyroids even with levels above 4 mlU/L.

“Can we do a second TSH test to confirm that finding?” A single TSH test can produce a misleading result.

“Do I have hypothyroidism or ­‘subclinical’ hypothyroidism?” Subclinical hypothyroidism means that your TSH level is a bit high, but your level of thyroxine (T4, another thyroid hormone) is fine. Doctors sometimes prescribe synthetic thyroid hormone in these situations, but a study published earlier this year in The New England Journal of Medicine found no benefit to doing so, at least among people age 65 and up.

“Did I test positive for anti-­thyroid antibodies?” If the answer is yes, you may have Hashimoto’s thyroiditis, an autoimmune condition that causes a gradual loss of thyroid function. That would strongly support your doctor’s decision to prescribe hormones (or to monitor your TSH levels closely).

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