In this chapter, we explore how thyroid disease manifests in people older than sixty, when people can be managing a number of conditions, including heart disease, arthritis, osteoporosis, as well as neurological diseases, such as Alzheimer's. In 1886, the physician Victor Horsley put forth the theory that the "aged face" was actually a hypothyroid face, leading many physicians of his day to conclude that thyroid disease was a disease of the aged. The fact is that about 4 to 7 percent of people older than sixty are definitely hypothyroid, but it's suspected that a much greater percentage of people have subclinical hypothyroidism after age sixty that frequently goes unrecognized and untreated. Meanwhile, less than 1 percent of people older than sixty suffer from hyperthyroidism. In either case, the symptoms of hypothyroidism and hyperthyroidism are different in older people, and do not manifest in the same ways as they do in a younger person.
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