A Comparison of rh-TSH and Thyroid Hormone Withdrawal in Patients with Differentiated Thyroid Cancer: Preliminary Evidence for an Influence of Age on the Subjective Well-being in Hypothyroidism

Abstract

We aimed to investigate the subjective well-being in patients with differentiated thyroid cancer after hormone withdrawal. Since this might be confounded by psycho-oncological processes unrelated to hypothyroidism we intended to minimize such factors by only including patients with a history of uneventful follow-up examinations for several years. We investigated 67 patients applying the General Health Questionnaire (GHQ-12) at 3 time points t1, t2, and t3. The time point t2 represented an intensified follow-up examination 5 years after thyroidectomy, which was performed either on hormone withdrawal (49 patients) or using rh-TSH (18 patients). The time points t1 and t3 took place during follow-up examinations 6 months before and after t2 in a euthyroid state. Additionally, we assessed the impact of age, gender, family status, and education on the GHQ-12 score at all 3 time points. Within the hormone withdrawal group the analyses demonstrated a significant difference between t1 and t2 as well as t3 and t2. Additionally, there was a significant negative correlation of age with GHQ-12 sum scores at t2, but not at t1 or t3. Subgroup analyses at t2 indicated that the subjective well-being in younger patients was more impaired compared to elderly patients. The between-group analysis showed no significant differences. However, concerning the age effect there was a significant difference between the subgroup of young hypothyroid patients and the total rh-TSH group at t2. We demonstrated preliminary evidence for an influence of age on the subjective well-being in hypothyroidism suggesting that younger subjects are subjectively more impaired by hypothyroidism than elderly ones.

Thyroid Hormone Effects on Sensory Perception, Mental Speed, Neuronal Excitability and Ion Channel Regulation

“…Our findings, that younger persons are more impaired than older subjects after thyroid hormone withdrawal is in accordance with recent findings by Heinzel et al, who reported a stronger subjective impairment in younger patients after thyroid hormone withdrawal than in older patients (46). This is in accordance with observations of age-dependent effects on heart action potential parameters observed to parallel age-related thyroid states (47,48).…”

Impact of Renal Function and Demographic/Anthropomorphic Variables on Peak Thyrotropin After Recombinant Human Thyrotropin Stimulation: A Stepwise Forward Multiple-Regression Analysis

“…Besides the somatic symptoms of hypothyroidism, the subjective perception of quality of life is considerably better in patients treated with rhTSH than in patients after thyroid hormone withdrawal (1,2). This is especially true in younger patients with DTC (3).…”

Preoperative Measurement of Serum Thyroglobulin to Predict Malignancy in Thyroid Nodules: A Systematic Review

“…Serum thyroglobulin determination is the pivotal tool during follow-up of patients treated for differentiated thyroid cancers [1]. After thyroid cells ablation by thyroidectomy and radioiodine, as verified by whole body scan (WBS), Tg is expected to be undetectable; consequently, detectable Tg levels may indicate tumor recurrence or metastasis [26][27][28]. In addition, Tg measurement has been ascribed as a potential predictor of malignancy in patients with thyroid nodules with controversial data.…”