Hipotireoidismo subclínico em idosos na atenção primária: ênfase na prevenção quaternária.

The diagnosis of subclinical hypothyroidism (SCH) in the elderly is highly difficult due to the changes of aging. Our goal was to track and assess the value of TSH for HSC intervention in asymptomatic elderly seen in primary care. We perform FT4 and TSH, TSH using the references for adults and age group (group A: 60-69 years; B: 70-79 years and C: greater than 80 years). The HSC was defined as normal FT4 and TSH above normal limit to 10 mIU/L. We evaluated 123 elderly people, 35 men and 88 women. The HSC was diagnosed in 8.1% (n = 10) of the elderly, with no difference by gender. The mean TSH was higher in the group with more than 80 years (p = 0.004). We observed an increase of HSC ratio considering the limit for adult (A: 3.5%; B: 5% e C: 15.4%; p < 0.05) and age group (A: 7%; B: 5% e C: 11.5%; NS). There was a directly proportional relationship of TSH (r^2 = 0.93, p < 0.01) and FT4 (r^2 = 0.54, p<0.01) with age. We conclude that the HSC is common in the elderly. TSH levels correlate and increases with age, and can represent a physiological increase with a possible cardioprotective role, greater functionality and longevity. The TSH should be assessed by age and confirmed track, avoiding misdiagnosis and unnecessary treatments, following the precept of quaternary prevention. It is important that family and community doctors, responsible for the coordination of care, be attentive to the HSC approach in the elderly. [ABSTRACT FROM AUTHOR]