Adequately treated patients with hypothyroidism
feel less well than other patients
(March 2003)
The background of
the study. Some patients with hypothyroidism do not feel
well despite adequate treatment with thyroxine (T4), as determined
by measurements of serum thyrotropin (TSH). In this study the well-being
of a large number of patients with hypothyroidism treated with T4
was assessed.
How the study was done. The study
subjects were 961 adults who had been taking T4 for at least four
months. These patients and 961 age- and sex-matched patients not
taking T4 were sent a three-part questionnaire. One part consisted
of questions about medical conditions, the second part questions
about psychological well-being, and the third part questions about
symptoms of thyroid dysfunction. Possible responses to the questions
about well-being ranged from better than usual (low score) to much
less than usual (high score). The responses to the thyroid questionnaire
ranged from symptom absent to symptom present; higher scores indicated
lesser well-being or more thyroid symptoms.
The results of the study. Questionnaires
were returned by 597 patients (62 percent) in the T4-therapy group
and 551 patients (57 percent) in the control group. The respondents
in the T4-therapy and control groups were 60 and 59 years old, respectively;
85 and 87 percent, respectively, were women. The frequency of diabetes,
cardiovascular disease, hypertension, and depression was higher
in the T4-therapy group than in the control group.
The patients taking T4 scored slightly higher on both the psychological
well-being questionnaire and the thyroid-symptom questionnaire,
as compared with the control group. The results were similar in
the patients taking T4 who had had a normal or abnormal serum TSH
concentration in the past year.
The conclusions of the study. Patients
with hypothyroidism receiving adequate T4 therapy do not feel as
well as other patients of the same age and sex.
The original article. Saravanan
P, Chau WF, Roberts N. Vedhara K, Greenwood R, Dayan CM. Psychological
well-being in patients on 'adequate' doses of L-thyroxine: results
of a large, controlled community-based questionnaire study. Clin
Endocrinol 2002;57:577-85.
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