Health status in patients with sub-clinical hypothyroidism

Abstract

Objective: Sub-clinical hypothyroidism (SCH) is a common disorder. People with this condition may have symptoms which could affect their perception of health. Therefore, the perceived health status of people with SCH was assessed and compared with population-matched norms. Design: A prospective cross-sectional survey. Methods: Seventy-one adults with SCH, age range 18-64 years were studied. Perceived health status was measured by the Short Form-36 (SF-36) version 2 questionaire, which has been validated in a UK population setting. The SF-36 has eight scales measuring physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional and mental health. Their SF-36 scores were compared with UK normative data after matching for age and sex and are reported as z-scores. Results: Scores of all eight SF-36 scales were significantly lower in people with SCH compared with the normative population. A negative score (compared with zero of the normative population) indicates worse health status. The most significantly impaired aspects of health status were vitality and role limitations due to physical problems (role physical scale) with z-scores (95% confidence intervals) of 21.01 (2 0.74 to 2 1.29) and 20.73 (20.43 to 2 1.04) respectively. Thyroid autoimmunity did not influence the results. Conclusion: Perceived health status is significantly impaired in people with SCH when compared with UK normative population scores. This needs to be taken into consideration by clinicians when managing patients with this disease.European Journal of Endocrinology 152 713-717

Evaluation of health-related quality of life in patients with Cushing's syndrome with a new questionnaire

“…Eighty percent of these patients had concomitant diseases (mostly hypertension, diabetes mellitus, depression, and osteoporosis), confirming that CS patients are a sick population (1). This is also evidenced when SF-36 results obtained in different endocrine diseases such as adrenal insufficiency (24,25), primary hyperparathyroidism (26), thyroid carcinoma (27), craniopharyngioma (28), and subclinical hypothyroidism (29) are compared, since all scored better than the CS cohort reported here but worse than normal population.…”

Management of Subclinical Hypothyroidism: The Thyroidologists’ View

“…More than three-quarters of individuals with SCH have serum TSH concentrations between 5 and 10 mU/l. Although treatment of the mild thyroid failure of SCH with levothyroxine would seem to be a logical approach to management, only a minority of individuals with SCH have symptoms that are typical of hypothyroidism [4,5,6]. Furthermore, there is scant evidence that symptoms of hypothyroidism, or health-related quality of life, improve following levothyroxine treatment of SCH [7,8,9,10].…”

Quality of life in patients with benign thyroid disorders. A review

“…To date, no trial has compared validly the HRQL outcome of different treatments and there is still a well-documented lack of consensus regarding choice of treatment (6 -15). The detrimental impact of acute thyroid disease on HRQL is obvious and has been documented in several studies (16)(17)(18). However, it is the clinical experience of many endocrinologists that some patients have residual complaints despite adequate medical treatment.…”