Screening for thyroid disease at the menopausal clinic.
The prevalence of hypothyroidism has been reported to increase with age and to attain up to 10% in older women. We wanted to verify whether routine screening for thyroid disease could be justified in a specific sub-population of aging women, those consulting for the first time at a menopausal clinic. Standard thyroid profiles (Total T4, T3 uptake, calculated free thyroxine index (FTI), and sensitive thyroid stimulating hormone (TSH)) were obtained in 500 consecutive patients seen at such a clinic over 18 months. Thyroid microsomal and thyroglobulin antibody titers were also obtained in over half of them. Twenty-three carefully selected, age-matched, peri-menopausal hospital employees served as a reference group for the TRH response test. Thirteen women (2.6%) had previously diagnosed hypothyroidism but 4 of them were found to be sub-optimally treated. Fifty other subjects (10%) had out-of-range screening TSH levels, 7 below and 43 over the assay reference range. In the former, 3 (0.6%) were found to be hyperthyroid while in the latter 8 (1.6%) were found to be overtly hypothyroid based on TSH levels over 10 mU/L and accompanying signs and symptoms. Twelve other subjects (2.4%) were found to have sub-clinical hypothyroidism based on a positive TRH response test and a significantly increased prevalence of goiter and positive antibody titers. The remaining 23 patients had a normal TRH response test, although their mean TSH level at 30-min post-TRH and the prevalence of positive antibody titers were significantly higher than those of the control group and normal subjects respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
Faughnan
M
M
Centre de recherche clinique André-Viallet, Hôpital Saint-Luc, Montréal, Québec.
Lepage
R
R
Fugère
P
P
Bissonnette
F
F
Brossard
J H
JH
D'Amour
P
P
D000554:Ambulatory Care Facilities; D001323:Autoantibodies / Q000097:blood; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000175:diagnosis*; D008403:Mass Screening / Q000706:statistics & numerical data*; D016555:Matched-Pair Analysis; D008593:Menopause; D008875:Middle Aged; D013954:Thyroglobulin / Q000276:immunology; D013959:Thyroid Diseases / Q000175:diagnosis*; D013960:Thyroid Function Tests; D013972:Thyrotropin / Q000097:blood; D013973:Thyrotropin-Releasing Hormone; D013974:Thyroxine / Q000097:blood; D014284:Triiodothyronine / Q000097:blood
D001323:Autoantibodies; D015415:Biomarkers; C006606:anti-thyroglobulin; D014284:Triiodothyronine; D013973:Thyrotropin-Releasing Hormone; D013972:Thyrotropin; D013954:Thyroglobulin; D013974:Thyroxine