Quality of life in longterm exogenous subclinical hyperthyroidism and the effects of restoration of euthyroidism, a randomized controlled trial.

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.

• 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)

Chemical References

• Thyroid Hormones
• Thyrotropin
• Thyroxine

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