It is characterized by a bumpy, lumpy enlarged thyroid with nodules that are overactive. The symptoms, however, are not as pronounced in older patients as they are in younger patients with hyperthyroidism. It results in an enlargement of the thyroid gland, caused by an autoimmune condition in which the body defenses turn on some of the organs of the body, instead of attacking foreign invaders like bacteria or viruses. The textbooks describe typical presentations in younger patients where hyper and hypothyroidism look like two very different entities. In older patients, however, these two conditions often present in exactly the same way.
Correct diagnosis is thus extremely difficult but critical.
Top Case history Let me tell you a case history of a patient I was asked to see about five years ago in one of the nursing homes. She was about 94 years old and about eight months earlier she had developed fibrillation of her heart that didn't respond to the usual medications to bring the heart into a more regular, more controlled heartbeat. In the ensuing months she became very weak and bound to bed. She became progressively confused and when I was asked to see hear, she had lost about sixty pounds, she'd been incontinent for many weeks, her skin was starting to break down, she was severely demented and we couldn't have a conversation with her. Now I could take you into almost any nursing home in Metro and show you many patients with similar symptoms who do not have thyroid disease.