A Lifestyle (Dietary) Intervention Reduces Tiredness in Children with Subclinical Hypothyroidism, a Randomized Controlled Trial

Abstract

Purpose: Subclinical hypothyroidism (SH) in children and adults is a subject for discussion in terms of whether to treat it or not with respect to the short-term clinical implications and consequences of SH and in the long term. If treatment with thyroxine supplementation is not indicated, no other treatment is available. We investigated whether a lifestyle (dietary) intervention improves or normalizes SH or decreases the presence of Thyroid Stimulating Hormone (TSH) and/or tiredness. Methods: We randomized children aged 1–12 years with SH to the control group (standard care = no treatment) or intervention group (dietary intervention). The dietary intervention consisted of green vegetables, beef, whole milk and butter for 6 months. The rest of the diet remained unchanged. We measured TSH, FreeT4, Lipid profile, Body Mass Index (BMI) and Pediatric Quality of Life (PedQL) multidimensional fatigue scale scores. Results: In total, 62 children were included. After 6 months, TSH decreased in both groups without a significant difference between the groups (p = 0.98). PedQL fatigue scores for sleep (p = 0.032) and total fatigue scores (p = 0.039) improved significantly in the intervention group, compared to the control group. No unfavorable effects occurred in the lipid profile or BMI. Conclusion: The lifestyle (dietary) intervention did not normalize SH and TSH levels, but it significantly reduced tiredness. These results suggest that children’s well-being can be improved without medication.

Health behaviours and degree of acceptance of disease and eating habits among patients with hypothyroidism and Hashimoto’s autoimmune thyroiditis

“…The respondent specifies how often within the last year he/she performed activities related with health, using a 5-point scale: 1 -almost never, 2 -rarely, 3 -sometimes, 4 -frequently, 5 -almost always, and may obtain 24-120 scores. The overall result is then converted into stens, where: 1-4 stens means low, 5-6 mediocre, and 7-10 -high intensity of health behaviours [4].…”

“…A scale devised by B. J. Felton, T. A. Revenson and G. A. Hinrichsen. In the presented study, the Polish version was used as adapted by Zygfryd Juczyński [4]). The questionnaire allows measurement of the extent to which a patient accepts own illness.…”

“…An important factor among health behaviours, among others, concerns diet and the maintenance of proper nutritional habits. According to studies, an appropriately balanced diet results in a considerable decrease in the feeling of fatigue which often occurs in patients [4]. Maintenance of health promoting life style leads to caring for health.…”

What Is the Quality of Life in Patients Treated with Levothyroxine for Hypothyroidism and How Are We Measuring It? A Critical, Narrative Review

“…A few nonrandomized studies found that some QoL benefits were associated with LT4 + LT3 combination therapy ( Table 3 ). In an open-label longitudinal cohort study of a switch to LT4 + LT3, Michaelsson et al (2018) reported that the ThyPRO-39 score fell (indicating a reduction in symptoms of hypothyroidism and better QoL) from 54 [ 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 ] at baseline to 15 [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ,…”

“…Other factors that may influence QoL in hypothyroidism include endurance exercise [ 62 ], dietary intervention (a diet with green vegetables, beef, whole milk, and butter) [ 64 ], higher level of antibodies against thyroid peroxidase [ 86 ], the occurrence of severe adverse drug reactions [ 77 ], tablet vs. liquid LT4 formulations [ 44 , 80 ], morning vs. evening LT4 administration [ 58 , 85 ], male gender, the duration of hypothyroidism, frequent visits to the general practitioner before diagnosis, negative experiences with LT4, high expectations of LT4, and the provision of support by the general practitioner [ 104 ]. However, these factors have not been extensively characterized, and their specificity and selectivity remain to be determined.…”