Effect of Thyroid-Stimulating Hormone Suppression on Muscle Function After Total Thyroidectomy in Patients With Thyroid Cancer

Abstract

ContextThyroid-stimulating hormone (TSH) suppression is recommended to reduce tumor recurrence following surgery for differentiated thyroid cancer (DTC). However, prolonged subclinical hyperthyroidism caused by levothyroxine treatment has deleterious effects on various organs.ObjectiveTo evaluate the relationships of TSH concentration with muscle mass, muscle strength, and physical performance related to sarcopenia in patients with DTC undergoing TSH suppression following surgery.MethodsWe studied 134 patients of >60 years who were undergoing TSH suppression therapy following surgery for DTC. We evaluated muscle mass and muscle function-related parameters and diagnosed sarcopenia using the threshold for Asian people.ResultsThe participants were 68.3 ± 7.2 years old and 36/134 (26.9%) were diagnosed with sarcopenia. They were allocated to high-TSH and low-TSH groups using a threshold concentration of 0.40 μU/mL, and grip strength was significantly lower in the low-TSH group. The data were further analyzed according to age and sex, and in the low-TSH group, male participants and those of <70 years were found to have significantly lower grip strength.ConclusionsLow-TSH concentrations is associated with low grip strength, and this is most pronounced in individuals of <70 years of age. Therefore, muscle function should be considered an adverse effect of TSH suppression in patients with DTC who undergo TSH suppression therapy, especially in men of <70 years.

Change in pericardial fat volume in postmenopausal women with papillary thyroid cancer undergoing TSH suppressive therapy

“…However, in subclinical hyperthyroidism induced by TSH suppression therapy after total thyroidectomy, ambiguous results have been observed. Some studies have reported that thyroxine therapy does not affect muscle mass or fat mass [50][51][52], but others have reported that muscle function is reduced in patients with subclinical hyperthyroidism after total thyroidectomy [53]. Our results are consistent with those of the former of these studies.…”

Metabolite Changes during the Transition from Hyperthyroidism to Euthyroidism in Patients with Graves’ Disease

“…GD-mediated thyrotoxicosis increases resting energy expenditure, body temperature, and heart rate [1]. Patients with GD usually exhibit accelerated whole-body catabolism due to increased oxygen consumption and thermogenesis, resulting in weight loss [2,3]. Moreover, an excess of thyroid hormones induces lipolysis and gluconeogenesis as well as a reduction of cholesterol levels [4][5][6].…”

Quality of Life of Survivors of Thyroid Cancer Is Not Inferior to That in Subjects without Cancer: Long-Term after Over 5 Years

“…HRQoL negatively correlated with TSH suppression [10,[36][37][38][39]. In addition to the total HRQoL, chronic subclinical hyperthyroidism or hyperthyroidism can cause medical problems such as cardiovascular complications [6], bone disease [7], muscle dysfunction [40], and metabolic disease [8].…”