71-Year-Old Female Patient with Thyroiditis: The Importance of Daily Management and Holistic Care

Thyroid disorders can significantly impact overall health, especially in elderly patients with pre-existing chronic conditions. This case study explores the journey of a 71-year-old woman managing both long-term type 1 diabetes and newly diagnosed thyroiditis. While her initial symptoms—such as dizziness, palpitations, and poor sleep—were subtle, they signaled an underlying imbalance that required prompt medical attention. After thorough evaluation and targeted treatment at Xi'an Jiaotong University First Affiliated Hospital in September 2020, her condition stabilized successfully. This article highlights the importance of integrated care, symptom monitoring, and lifestyle adjustments for older adults navigating complex health challenges.

Understanding the Diagnosis: What Is Thyroiditis?

Thyroiditis refers to inflammation of the thyroid gland, which can disrupt hormone production and lead to either hyperthyroidism or hypothyroidism depending on the stage and type. In this case, the patient presented with signs consistent with subacute or autoimmune thyroiditis, likely triggered by immune system fluctuations linked to poorly controlled blood sugar levels over time.

Key diagnostic indicators included elevated high-sensitivity TSH (11.45 µIU/mL), abnormal thyroid ultrasound findings showing low-echoic flocculent material within the gland, and clinical symptoms such as palpitations and intermittent dizziness. These clues helped clinicians pinpoint the root cause behind her recent decline in well-being.

Patient Profile at a Glance

Gender: Female
Age: 71 years
Medical History: Type 1 diabetes for 21 years
Hospital: First Affiliated Hospital of Xi'an Jiaotong University
Treatment Duration: One week of inpatient care followed by ongoing outpatient follow-up
Primary Treatment Plan: Combination therapy including oral medications and insulin injections

Initial Clinical Assessment and Symptom Presentation

Upon first consultation, the patient was alert and cooperative, though visibly fatigued. She reported a one-month history of worsening glycemic control despite adhering to her usual insulin regimen—specifically, daily subcutaneous injections of insulin lispro and insulin glargine. Alongside unstable glucose readings, she experienced disrupted sleep patterns and recurrent episodes of lightheadedness and heart palpitations without any obvious triggers.

Physical examination revealed no jaundice, bleeding spots, neck stiffness, or enlarged veins. The trachea was midline, and no thyroid enlargement was detected upon palpation. However, laboratory tests showed mild monocytosis (0.65 × 10⁹/L), while imaging confirmed structural changes in the thyroid tissue—hallmarks of inflammatory activity.

Comprehensive Treatment Approach

After discussing options with the patient and her family, we initiated a dual-pronged therapeutic strategy focused on symptom relief and metabolic stabilization:

Medication Regimen

Propranolol hydrochloride tablets were prescribed orally to alleviate tachycardia and reduce anxiety-like symptoms associated with thyroid dysfunction. This beta-blocker is commonly used during early phases of thyroiditis to manage cardiovascular side effects caused by excess thyroid hormones.

For pain management—particularly when discomfort arose from glandular inflammation—we introduced ibuprofen sustained-release capsules, ensuring improved quality of life during recovery.

Simultaneously, strict glycemic control remained critical. The patient continued using insulin glargine for basal coverage and insulin lispro for mealtime correction via subcutaneous injection, adjusted based on frequent glucose checks.

Observed Treatment Outcomes

The response to treatment was encouraging. By day three of hospitalization, the frequency of dizziness and palpitations had decreased noticeably. Blood glucose levels began stabilizing, reflecting better hormonal balance and improved insulin sensitivity.

After seven days of structured care, all acute symptoms had resolved. Laboratory results confirmed normalization of white blood cell count, indicating resolution of systemic inflammation. With stable vitals and restored energy levels, the patient was discharged with clear instructions for continued home-based monitoring and follow-up appointments.

Ongoing Management Tips for Patients with Chronic Conditions

Recovery doesn't end at discharge. For seniors managing multiple health issues like diabetes and thyroid disease, long-term wellness depends heavily on proactive self-care. Here are essential recommendations:

Nutrition: Fuel Your Body Wisely

A balanced diet rich in lean proteins (like fish and poultry), fresh fruits, vegetables, and whole grains supports immune function and metabolic health. Incorporating moderate amounts of iodine-rich foods—such as seaweed and nori—can benefit thyroid function, but excessive intake should be avoided to prevent further disruption.

Equally important is limiting processed foods high in salt, added sugars, and unhealthy fats, which can worsen insulin resistance and increase cardiovascular risk.

Stay Active—Safely and Consistently

Regular physical activity plays a vital role in maintaining both metabolic and mental health. Low-impact exercises such as walking, gentle aerobics, or chair-based workouts for 30 minutes most days of the week can enhance circulation, improve mood, and support glucose regulation.

However, intense or exhaustive workouts should be avoided, particularly during active phases of illness, to prevent strain on the heart and endocrine system.

Monitor Key Health Markers Regularly

Diligent tracking is key to preventing complications. Patients should check their blood glucose levels 3–4 times daily and keep a log for review during doctor visits. Additionally, routine screening should include:

Eye exams to detect diabetic retinopathy
Urine tests for microalbuminuria (early kidney damage)
Liver and kidney function panels
Thyroid function tests (TSH, T3, T4)
Periodic thyroid ultrasounds if structural abnormalities persist

Clinical Insights: Why Proactive Care Matters

This case underscores how seemingly minor shifts in health—like temporary sleep disturbances or occasional dizziness—can signal deeper physiological imbalances, especially in aging individuals with chronic diseases. The interplay between uncontrolled diabetes and emerging thyroiditis illustrates the body's interconnected systems: poor glycemic control weakens immunity, increasing susceptibility to infections and autoimmune flare-ups.

Fortunately, with timely diagnosis and coordinated treatment, even older patients can achieve excellent outcomes. Early intervention not only relieves symptoms but also prevents long-term complications such as cardiac arrhythmias, osteoporosis, or permanent gland damage.

Final Thoughts: Empowering Patients Through Education

Living with chronic illness requires more than medication—it demands awareness, discipline, and support. Educating patients about their conditions empowers them to recognize warning signs early and seek help before small issues become emergencies.

For individuals like this 71-year-old patient, consistency in medication use, healthy lifestyle choices, and regular medical follow-ups form the foundation of lasting wellness. With proper daily management, it's entirely possible to live fully—even with complex health needs.