Any advice for those of us over 60? My first thyroid issue was the discovery of nodules in 2001 during pre-surgical (rt. oophorectomy) screening. Ultrasound and biopsy were negative for thyroid malignancy and I continued to follow up with US about every 18 months. I was diagnosed with hyperthyroidism in 2010, although my first low TSH was in 2003, with no follow-up care necessary, according to MD. He said it was probably a temporary issue related to perimenopause. As symptoms worsened–especially rapid heartbeat and anxiety– in 2010 fnally consulted an endo. who told me I had mild hyperthyroidism, ordered an uptake and said the hyper was grounded in toxic multinodular goiter. Have been on 2.5 tapazole since June 2010. Low dose due to multi medication sensitivity. My levels have been mostly in low normal range, but drop with stress. No beta blockers so far, although I continue to have PVC's and PAC's. After consulting with at least 4 endos. for treatment options and prognosis, I have concluded that the only consistent dynamic is that there is no agreement about treatment and the more gray hair one has, the less time is spent trying to figure out a treatment plan. My current endo. has changed diagnosis (last month) to Graves'. He reviewed my records and said his adjusted diagnosed was based on uptake % and consistently normal T3 and T4, the fact that I have other autoimmune issues, and the fact that antibody tests were not performed before beginning treatment. I'm even more confused and am arranging a consultation with a physician affiliated with a major medical college and university hospital in a nearby city. I feel that because of a complicated medical history and my age, some of the local endos. have just wanted to give me the “textbook chapter” on thyroid and get me out the door. Really get the feeling that once we hit “senior,” the attitude is that we've got fewer years ahead of us than behind us, so why bother to take time to figure out what's best? Obviously, the final decision is mine, but I believe everyone has the right to accurate, current information that is presented without bias. The very basics of good decision making. I am not my thyroid and I refuse to be defined by hyperthyroidism or Graves' or toxic anything! I still have something, many things, to contribute to this wonderfully crazy world and I respectfully solicit advice because I know the best information comes from experience. Thank you!

Hello and welcome! Hopefully, the medical center that you have the appointment with will be able to give you a definitive diagnosis. Once you have a diagnosis, that will help shape your treatment options.

If you go to the “Announcements” section at the top of this forum, and go to the “Treatment Options” thread, there is a guidance document from the American Thyroid Association and American Association of Clinical Endocrinologists that deals with the treatment of hyperthyroidism – both due to Graves' and to toxic multinodular goiter. It was written for doctors, but the language is pretty clear, without a ton of medical jargon.

As for conflicting opinions in the medical community, that tends to be quite common with Graves' – and not just for those in a certain age bracket. There is unfortunately a lot about Graves' and autoimmunity that just isn't well understood…and other issues where doctors have completely different opinions.

Take care – and keep us posted!

Many thanks for your welcome and reply and much gratitude for facilitating this forum.

I have read much about treatment over the past two years–some of the information good; some, not so much. Everything I have read, however good or not so good, does support the idea that hyperthyroidism in older folks may present differently and can be harder to diagnose because the symptoms and consequences are so similar to other health issues related to aging. Treatment plans may differ for the same reason. My frustration peaks when I explain symptoms and an MD responds, “Your levels are within normal bounds, so your symptoms can not be related to your thyroid. You are just getting older.” So, there's the rub. If symptoms are discounted, how can one arrive at an accurate diagnosis?
At this point, it would appear that getting an accurate diagnosis is the first step.
I'm staying positive and full of hope that a fresh perspective from an actual thryroid specialist will help me move forward. Will keep you posted.
Again, grateful for your work and this forum.

Hi, Maryelled–

Welcome to the forum! I'm a newbie myself. You'll find a lot of support and good advice here.

I wanted to tell you that when I first asked my endo (who I had seen for pre-diabetes issues) about all my hypo symptoms (I was hypo before I was hyper), he told me that all of the symptoms I was describing could be caused by peri-menopause. He's lucky I let him live! I said, really? Because I've had these symptoms for 30 years and I haven't been peri-menopausal for 30 years!!

It's bad enough to be sick, but to not be taken seriously because you are a woman and/or young or middle-aged or elderly is such an injustice. I hope you find the answers you're looking for with an endo who can respect you and not look at you as “the thyroid in room 6.”

Take care,
Amy

Thanks for sharing your experience, Amy. Yes,to everything you responded, and add to the list of “isms” that sometimes stand between patient and diagnosis, “information-ism” and “individual-ism.” You know, the eyes-glazing-over reaction when a patient asks questions that the doctor can't or won't answer, or the it's-all-in-your-head responses when we don't quite fit into the checklist of symptoms that pigeonhole diagnoses?
And, glory forbid, if we're women of a certain age or experience; if we ask questions, and expect to be treated as individuals who do happen to know a little something more about our bodies' peculiarities than the doctor; if we have learned self-advocacy skills and actually employ them, then we are labeled. For the sake of expedience, convenience and ego, not for the sake of our well-being. It is an injustice; one that limits access to appropriate treatment and possibilities for health.
I am grateful that most of my doctors do not fit this profile. However, the truth is that most of the “specialists” (endos.) I have encountered over the past two years have demonstrated a reluctance to move out of textbook mode. It's sad, and hopefully, some will get the message and reevaluate their practices and perspectives as we take our bodies and our business ($) elsewhere.
Peace and gratitude,
Mary

I'm a bit confused, maryelled. Why should doctors “move out of textbook mode?” I, personally, am a very numbers-based, fact-based person, and I find it comforting to know that millions of folks have been treated for Graves over the years by X, Y or Z treatment and gotten well again. Eventually. The thing is, I think that it gets harder as we get older to RECOVER from being hyperthyroid, just as it gets harder to recover from any serious illness as we get older. It's frustrating. (I'm approaching 70.) I recovered in a week from laproscopic gall bladder surgery when I was in my fifties, but it took me six weeks to recover from a similarly non-invasive procedure about five years ago. It takes us weeks/months AT normal levels of thyroid hormone to truly heal. It is not simply a question of getting to normal levels and feeling wonderful all at once.

Thanks, Bobbie. For sure. And, I am more than incidentally familiar with the experience of longer recovery time as we age. I must also factor into my healing process the other chronic illnesses that impact my ability to recover– Lyme disease, for example. But, you actually make my point. For those of us who are not “textbook” cases, those of us whose diagnoses must take into consideration many factors (including age), the pathway is much different, more complicated. If “facts” were always the answer, then I guess we'd all be diagnosed and treated more easily, quickly, accurately and restored to peak health. And, if that were the case, then I think those of us banging the drum for more research, more support for long term studies, etc. could stop the banging! Certainly we need guidelines, standards, best practices. But, facts do not always reflect larger truths, the “whole picture,” so to speak. It's become just too easy for some doctors to attribute everything to aging. And, for others, it's just too easy to attribute everything to hyperthyroidism. I feel that refusal to move from either extreme position is dangerous. It keeps us stuck, and closed off to possibilities, and often allows important health issues to become politicized ( diagnosis and treatment of Lyme Disease is a perfect example of this). Absolutism is never healthy. Bottom line for me is, after two years and four months of treatment with tapazole, I am feeling better. However, many symptoms persist; I have a complicated medical history–also facts– and there is no agreement on my actual diagnosis– all doctors claim that the “facts” support their particular diagnosis. That's pretty unsettling.

Boy can I relate on the aging issue. When I first went to the opthamologist about my double vision, his response was that I was aging. (I was 58!) I said, “Hmm, my mom is older than I am, she doesn't have double vision. Is double vision a normal aging process?”. Clearly something is causing it and I explained that I had been treated with RAI a year earlier. He still insisted it was that it was that I was getting older. He was going to give me prisms. I asked to see a neuro-opthalmologist and was given the diagnosis of TED.

Barb