Abstract | OBJECTIVE: The impact of prolonged subclinical hyperthyroidism on quality of life is unclear. Therefore, we evaluated quality of life in patients with differentiated thyroid carcinoma (DTC) on TSH-suppressive thyroxine therapy as a model for subclinical hyperthyroidism and we investigated whether restoration to euthyroidism affects quality of life. DESIGN: We performed a prospective, single-blinded, placebo-controlled, randomized trial of 6 months' duration with two parallel groups. PATIENTS AND METHODS: Twenty-four subjects with a history of differentiated thyroid carcinoma with > 10 years TSH-suppressive therapy with L-thyroxine completed the study. L-thyroxine dose was replaced by study medication containing L-thyroxine or L-thyroxine plus placebo. Medication was titrated to establish continuation of TSH suppression (low-TSH group) and euthyroidism (euthyroid group). Both groups consisted of 12 patients. We evaluated quality of life using five validated questionnaires. RESULTS: At baseline, the somatic disorder questionnaire (SDQ) indicated more somatic dysfunction in patients as compared with reference values, whereas the depression score ( HADS) revealed a better score than the reference group. All other quality of life parameters were normal. At baseline, no significant differences between the low-TSH and the euthyroidism groups were observed. After 6 months, none of the quality of life parameters in the low-TSH group was different from baseline values. In the euthyroid group, motivation was significantly improved (Multidimensional Fatigue Index-20, P = 0.003), although this parameter did not differ from the reference group at baseline. A probable worsening in role limitations as a result of physical problems (Short Form-36; P = 0.050) was observed. No improvement in the SDQ score was observed. CONCLUSION: In summary, quality of life in patients with DTC and long-term subclinical hyperthyroidism in general is preserved. Restoration of euthyroidism in general does not affect quality of life.
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Authors | C F A Eustatia-Rutten, E P M Corssmit, A M Pereira, M Frölich, J J Bax, J A Romijn, J W A Smit |
Journal | Clinical endocrinology
(Clin Endocrinol (Oxf))
Vol. 64
Issue 3
Pg. 284-91
(Mar 2006)
ISSN: 0300-0664 [Print] England |
PMID | 16487438
(Publication Type: Journal Article, Randomized Controlled Trial)
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Chemical References |
- Thyroid Hormones
- Thyrotropin
- Thyroxine
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Topics |
- Fatigue
(psychology)
- Female
- Humans
- Hyperthyroidism
(drug therapy, etiology, physiopathology)
- Male
- Middle Aged
- Prospective Studies
- Psychiatric Status Rating Scales
- Quality of Life
- Single-Blind Method
- Surveys and Questionnaires
- Thyroid Gland
(drug effects, physiopathology)
- Thyroid Hormones
(blood)
- Thyroid Neoplasms
(complications, drug therapy, physiopathology)
- Thyrotropin
(antagonists & inhibitors, blood)
- Thyroxine
(therapeutic use)
- Treatment Outcome
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