UMEM Educational Pearls

Category: Endocrine

Title: Apathetic Hypothyroidism

Keywords: Hypothyroidism, Elderly (PubMed Search)

Posted: 8/15/2009 by Michael Bond, MD (Updated: 9/5/2009)
Click here to contact Michael Bond, MD

Apathetic Hypothyroidism AKA Hypothyroidism in the Elderly

Remember that elderly do not present with classic signs and symptoms of hypothyroidism, but rather it is more common for them to have atypical presentations.

Things that make the diagnosis more difficult in the elderly are:

  • The thyroid gland is often difficult to palpate.
  • Symptoms like weight gain, cold intolerance, and mental and physical decline are often attributed to the normal aging process.
  • Symptoms are often attributed to medications, or medications mask some of their symptoms.

Consider the diagnosis in elderly patients with:

  • Arrthymias
  • New onset dementia or increased “forgetfulness”
  • Depression
  • Failure to thrive
  • Anemia
  • Hyponatremia


Thyroid disorders in elderly patients.
Rehman SU, Cope DW, Senseney AD, Brzezi
South Med J. 2005 May;98(5):543-9. Review.