Benign, so-called “hot” thyroid nodules can trigger atrial fibrillation or osteoporosis in older people - even if the laboratory values are still normal or only indicate mild hyperthyroidism. That's why experts recommend having a laboratory test or an ultrasound scan from the age of 65.
In around five percent of people over 65, thyroid nodules trigger a mild overactive thyroid, a so-called latent hyperthyroidism. “The deceptive thing is: Even if a slight hyperfunction often does not cause any noticeable symptoms, especially in older people, it can have serious effects on the cardiovascular system and bone metabolism,” emphasizes Professor Dr. med. Detlef Moka, Chairman of the
Professional Association of German Nuclear Medicine Doctors (BDN).
The risk of vertebral fractures is more than twice as high
Thyroid dysfunction promotes osteoporosis and increases the risk of femoral neck fractures by 36 percent and the risk of vertebral body fractures by as much as 51 percent. Above all, overactivity promotes cardiac arrhythmias - it doubles the risk of atrial fibrillation - and thus increases the risk of strokes as well as cardiac death and heart failure, as new data shows.
Those affected often do not even notice that atrial fibrillation is an alarm signal. But cardiac arrhythmias promote the formation of blood clots that can break away from the heart and block an artery in the brain. Atrial fibrillation is the cause of at least one in five strokes. “The fact that even a slight hyperthyroidism can trigger osteoporosis and atrial fibrillation, these silent consequences of hot thyroid nodules are often underestimated in older people,” says Moka.
Hyperfunction in older people should be treated in the early stages
Hyperfunctions should therefore be treated in the early stages. “From the age of 65, you should check your TSH value with your family doctor and have an ultrasound scan for thyroid nodules done to be on the safe side,” advises Moka. If nodules larger than one centimeter are present, scintigraphy is recommended. “Hot nodules can be reliably identified with thyroid scintigraphy – often even before changes in the laboratory values become apparent,” explains the nuclear medicine specialist.
To treat hot nodules, which are almost always benign, medication, especially radioiodine therapy or surgery, can sometimes be considered. In addition, so-called minimally invasive procedures are available for benign nodules, which often use special needles (“probes”): radiofrequency ablation, microwave ablation, laser ablation or – not needle-based – highly focused ultrasound. “In any case, you should take action as you get older, even if you have mild hyperthyroidism, in order to reduce the risk of osteoporosis and stroke,” says Moka.
This article only contains general information on the respective health topic and is therefore not intended for self-diagnosis, treatment or medication. It in no way replaces a visit to the doctor. Unfortunately, our editorial team cannot answer individual questions about medical conditions.