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Wilmar M. Wiersinga Department of Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

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mortality [ 23 ]. It suggests tolerance for lower thyroid hormone levels in older people, in agreement with the guidelines to be rather conservative in prescribing levothyroxine to elderly subjects with SHypo [ 2 ]. The data support shifting the upper normal

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Roberto Negro Division of Endocrinology, “V. Fazzi” Hospital, Lecce

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Roberto Attanasio Endocrinology Service, Galeazzi Institute IRCCS, Milan

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Franco Grimaldi Endocrinology and Metabolic Disease Unit, Azienda Ospedaliero-Universitaria “S. Maria della Misericordia,” Udine

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Andrea Frasoldati Division of Endocrinology, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia

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Rinaldo Guglielmi Department of Endocrinology, Regina Apostolorum Hospital, Albano Laziale, Italy

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Enrico Papini Department of Endocrinology, Regina Apostolorum Hospital, Albano Laziale, Italy

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selected individuals, with higher frequencies in women and the elderly [ 1 , 2 ]. Most nodules are asymptomatic, are not associated with thyroid dysfunction, and do not cause compressive symptoms or cosmetic concerns. However, widespread use of imaging

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Roberto Negro Division of Endocrinology, ‘V. Fazzi' Hospital, Lecce

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Giacomo Greco Faculty of Medicine, San Raffaele Hospital, Milan, Italy

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A, Witteman JC: Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study. Ann Intern Med 2000;132:270-278. 10.7326/0003-4819-132-4-200002150-00004 10681281 3

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Rodrigo Moreno-Reyes Department of Nuclear Medicine, Hospital Erasme, Université Libre de Bruxelles, Brussels, Belgium

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Ulla Feldt-Rasmussen Department of Endocrinology and Metabolism, University Hospital Rigshospitalet, and Faculty of Ηealth and Clinical Sciences, University of Copenhagen, Copenhagen, Denmark

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Agnieszka Piekiełko-Witkowska Centre of Postgraduate Medical Education, Centre of Translational Research, Department of Biochemistry and Molecular Biology, Warsaw, Poland: Basic Lead of the European Society of Endocrinology Focus Area on Thyroid

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Adriana Gaspar da Rocha Public Health Unit, ULS Baixo Mondego, Figueira da Foz, Portugal Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal Health Investigation and Innovation Institute (i3S), University of Porto, Porto, Portugal

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Corin Badiu National Institute of Endocrinology "C. Davila" University of Medicine and Pharmacy, Bucharest, Romania

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Josef Köhrle Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institut für Experimentelle Endokrinologie, Berlin, Germany: Co-Lead of the European Society of Endocrinology Focus Area on Environmental Endocrinology

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Leonidas Duntas Evgenideion Hospital, Unit of Endocrinology, Metabolism and Diabetes, National Kapodistrian University of Athens, Athens, Greece

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Infertility, impaired mental function Decreased work capability Spontaneous hyperthyroidism in the elderly Iodine-induced hyperthyroidism Higher ratio of the more aggressive follicular to papillary thyroid cancers

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Francesca Orsolini Department of Clinical and Experimental Medicine, Endocrine Unit, University of Pisa, Pisa, Italy

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Alessandro Prete Department of Clinical and Experimental Medicine, Endocrine Unit, University of Pisa, Pisa, Italy

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Pierpaolo Falcetta Department of Clinical and Experimental Medicine, Endocrine Unit, University of Pisa, Pisa, Italy

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Domenico Canale Department of Clinical and Experimental Medicine, Endocrine Unit, University of Pisa, Pisa, Italy

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Fulvio Basolo Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy

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Greta Alì Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy

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Francesca Manassero Division of Urology, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy

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Paolo Vitti Department of Clinical and Experimental Medicine, Endocrine Unit, University of Pisa, Pisa, Italy

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Rossella Elisei Department of Clinical and Experimental Medicine, Endocrine Unit, University of Pisa, Pisa, Italy

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Eleonora Molinaro Department of Clinical and Experimental Medicine, Endocrine Unit, University of Pisa, Pisa, Italy

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metastases from the prostate are seen in the elderly, about one-third of patients with testicular metastasis from other cancer than prostatic one can present at a relatively younger age, as in the present case. Indeed, secondaries from the stomach and small

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Georgios Kostopoulos Department of Endocrinology and Metabolism, Ippokratio General Hospital of Thessaloniki, Greece

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Grigoris Effraimidis Department of Endocrinology and Metabolic Diseases, Larissa University Hospital, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece

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4189 5.7%  Auer et al. ( 17 ) 2001 Austria RS 23,638 –   Euthyroid 22,300 2.3%  oHT 725 Elderly 13.8% RR 5.8 (2.7–8.5)  Osman et al. ( 38 ) 2007 UK P

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Line Tang Møllehave Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark

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Nils Knudsen Department of Endocrinology, Bispebjerg University Hospital, University of Copenhagen, Denmark

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Allan Linneberg Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Inge Bülow Pedersen Department of Endocrinology and Medicine, Aalborg University Hospital, Aalborg, Denmark

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Gitte Ravn-Haren Research Group for Risk Benefit, National Food Institute, Technical University of Denmark, Lyngby, Denmark

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Anja Lykke Madsen Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark

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Allan Carlé Department of Endocrinology and Medicine, Aalborg University Hospital, Aalborg, Denmark

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Charlotte Cerqueira The Danish Clinical Quality Program – National Clinical Registries (RKKP), Denmark

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Anne Krejbjerg Department of Oncology, Aalborg University Hospital, Aalborg, Denmark

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Lone Banke Rasmussen Independent researcher, Klemensker, Denmark

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Lars Ovesen Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark

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Hans Perrild Department of Endocrinology, Bispebjerg University Hospital, University of Copenhagen, Denmark

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Lena Bjergved Sigurd Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Department of Internal Medicine, Copenhagen University Hospital – Herlev and Gentofte, Copenhagen, Denmark

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Betina Heinsbæk Thuesen Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark

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Pernille Vejbjerg Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark

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Torben Jørgensen Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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observations of ID were accompanied by observations of a higher prevalence of enlarged thyroid or goiter ( 7 ), thyroid nodules, and subsequent hyperthyroidism ( 10 , 11 ), especially in elderly women and in the most iodine-deficient areas ( 11 ). Further

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Henry Völzke Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany

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Iris Erlund Department of Public Health Solutions, National Institute for Health and Welfare (THL), Helsinki, Finland

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Alicja Hubalewska-Dydejczyk Department of Endocrinology, Jagiellonian University Medical College, Krakow, Poland

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Till Ittermann Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany

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Robin P. Peeters Department of Internal Medicine, Rotterdam Thyroid Centre, Erasmus Medical Centre, Rotterdam, The Netherlands

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Margaret Rayman University of Surrey, Surrey, United Kingdom

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Monika Buchberger Department of Public Health and Health Technology Assessment, UMIT, University for Health Science, Medical Informatics and Technology, Hall, Austria

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Uwe Siebert Department of Public Health and Health Technology Assessment, UMIT, University for Health Science, Medical Informatics and Technology, Hall, Austria

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Betina H. Thuesen Research Centre for Prevention and Health, Glostrup, Denmark

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Michael B. Zimmermann Swiss Federal Institute of Technology, Zürich Department of Health Sciences and Technology, Zürich, Switzerland

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Stefan Grünert Biolution GmbH, Vienna, Austria

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John H. Lazarus Institute of Molecular Medicine, Cardiff University, Cardiff, United Kingdom

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, Pedersen KM, Hreidarsson A, Sigfusson N, Iversen E, Knudsen PR: Iodine intake and the pattern of thyroid disorders: a comparative epidemiological study of thyroid abnormalities in the elderly in Iceland and in Jutland, Denmark. J Clin Endocrinol Metab 1998

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Chi-Yu Kuo Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan

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Po-Sheng Yang Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan

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Ming-Nan Chien Division of Endocrinology and Metabolism, Department of Internal Medicine, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan

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Shih-Ping Cheng Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan
Department of Pharmacology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

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profiling in elderly cancer patients reveals aging-altered immune cells and immune checkpoints . Int J Cancer . 2019 Apr ; 144 ( 7 ): 1657 – 63 . 10.1002/ijc.31875 30230534 0020-7136 32 Schmid D , Ricci C , Behrens G , Leitzmann MF

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Ladan Mehran Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

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Atieh Amouzegar Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

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Hengameh Abdi Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

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Negar Delbari Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

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Elham Madreseh Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

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Maryam Tohidi Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

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Mohammad Ali Mansournia Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

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Fereidoun Azizi Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

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findings to other populations. Coexistence of MetS and TD may aggravate their common metabolic features which might strongly impact the health of populations especially in hypothyroid elderly subjects regarding cardiovascular and metabolic risk factors

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