Endocrine and Aging Flashcards
What happens to GH axis in aging?
Decrease in GH results in decrease in IGF-1 (somatopause)
What happens in HPG axis in aging?
Decline in LH/FSH leads to decrease in estrogen/tesosterone
menopause/andropause
What happens in HPA axis in aging?
Same amounts of ACTH and cortisol, but decreased DHEA response (adrenopause)
What are the four “pauses” of aging?
Menopause
Andropause
Adrenopause
Somatopause
Women’s Health Initiative: What were results of chronic ERT?
Estrogen alone=no risk or benefit
Non-statistically significant reduction in colon cancer, hip fracture
No statistcaly signifiant increase in CHD, stroke, breast cancer, VTE
Dosing regimen for menopause ERT?
Give lowest possible dose for symptomatic relief then taper
What age-related changes occur in male sex hormones? Why?
Reduction in tesosterone due to attrition of leydig cells
When do you measure testosterone levels? Why
8AM– levels highest in morning
How many men >40 receive androgen replacement therapy?
3%– rates probably higher, and unnecessarily high due to marketing
How do growth hormone pulsatility change with aging?
Same frequency but lower amplitude
What hormone increases as you age? What disease does this have implications for?
Cortisol levels increase with age. This affects insulin sensitivity/resistance, having implications for DM
Which endocrine disease have different presentation with aging? What changes occur in elderly?
Hyperthyroidism and hypothyroidism has non-classical presentation in elderly.
Hyper: Increased apathy and anorexia
Hypo: Increased anorexia/weight loss
What changes occur in TSH levels in older populations?
Shift: older populations have on average higher TSH– subclinical hypothyroidism
What thyroid-related change occurs in elderly despite apparent euthyroidism?
Atrial fibrillation, a sign of hyperthyroidism, increases even in patients with normal level TSH.
