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September 2018

Older patients over-tested for thyroid problems

A study in the British Journal of General Practice suggests that many of the millions of thyroid function tests carried out each year are unnecessary.

Disorders of the thyroid gland affect as many as 10 to 15% of people over the age of 65 and tests of thyroid function are performed on as many as 30% of older people, at an annual cost to the NHS of around £30 million.

Lesley Roberts and colleagues analysed data on almost 3,000 patients who had normal thyroid function at the outset and were re-tested after about 5 years. Only a tiny proportion of them showed any change in thyroid function – 17 cases in 12,919 person-years. At present thyroid function tests are frequently performed annually on older people, often in response to unexplained symptoms or as part of routine care or monitoring.

Based on these findings the Birmingham researchers recommend that routine repeat thyroid function testing in older people who have a normal thyroid function test result in the last five years is not advised, unless clinically indicated. As well as reducing workload and patient inconvenience, following this advice would lead to significant cost savings for the NHS.

Roberts L, et al. Br J Gen Pract 28 August 2018.