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Clinic for Endocrine Aging
About the Clinic
At the Johns Hopkins Clinic for Endocrine Aging, we appreciate the complexity of individual responses to the physical challenges presented by aging. We recognize that hormonal testing needs careful interpretation, with treatment approaches specifically crafted for older adults. Our staff are dedicated to understanding hormonal changes in context and tailoring treatment.
We are actively engaged in research to understand how hormones adapt to support healthy aging. In long-term studies, we can tell the differences between adaptation and disease using many years-worth of data. In contrast, most doctors and patients are trying to make decisions about treatment based on a single laboratory test of thyroid function.
Being thoughtful about the interpretation of current tests can support healthy aging, and a clinic dedicated to older adults like the Clinic for Endocrine Aging helps make that possible. In the future, new assays and assessments are needed to improve our diagnoses. Our research group is actively working to improve and personalize care through the development of diagnostic and therapeutic tools.
Who We Are
Thyroid in Aging
Mammen, 2017 (Thyroid 27(11) 1370):
Working with data from the Baltimore Longitudinal Study of Aging (https://www.nia.nih.gov/research/labs/blsa), we have recently reported new findings regarding changes in thyroid function with age. The pituitary hormone TSH is commonly used measure of the thyroid function, because it works on the thyroid like the pressure on a gas pedal. In younger individuals, a rise in TSH most often means that the thyroid is slowing down. In contrast, we reported that not all older adults with a rising TSH have a lower thyroid hormone level (known as hypothyroidism). These results tell us that different treatment approaches are appropriate in different individuals [WYPR #2]. In fact, some studies suggest that having a higher TSH is associated with longevity, and so may not need to be treated at all!
Simonsick, 2016 (J Geronotol A Biol 71(7) 961):
The rate of living hypothesis suggests that elevated energy demands increase wear and tear. Thyroid hormone is a major regulator of energy and our research suggests that lower thyroid hormone levels are associated with better physical function in older adults.
Mammen, 2015 (Thyroid 25(9) 979):
Studies on the use of thyroid replacement in our cohort and others show that older adults and particularly women are at high risk for thyroid hormone over-use and the associated harm to heart and bones [WYPR #1]. This constitutes a significant public health problem, driving our mission to fulfill the need for targeted therapy and bring personalized medicine to Endocrinology.
Make an Appointment
Anyone age 65 or older with thyroid, adrenal or pituitary concerns may be seen in the clinic for consultation. Those with osteoporosis or calcium disorders should schedule with the Metabolic Bone Center.
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