Mental Health Drives Life Quality in Treated Hypothyroidism

TOPLINE:

In patients with primary hypothyroidism receiving a stable dose of levothyroxine, thyroid-dependent quality of life (QOL) was driven by psychological factors, including somatosensory amplification and depression, and body mass index (BMI), rather than by thyroid biomarkers.

METHODOLOGY:

• Levothyroxine monotherapy to normalise serum thyrotropin (TSH) is the standard treatment for primary hypothyroidism and greatly improves symptoms and life expectancy, yet at least 1src%-15% of patients still experience persistent symptoms and reduced QOL despite having normal TSH levels.
• Researchers conducted a cross-sectional study (August 2src21 to 2src22) to examine predictors of QOL in 157 adults (mean age, 49.5 years) with primary hypothyroidism for more than 2 years who were free of major comorbidities and had been on a stable dose of levothyroxine monotherapy and maintained a normal TSH level for more than 6 months; 7src.7% of participants had autoimmune thyroiditis and 29.3% had iatrogenic hypothyroidism.
• Levels of various thyroid-specific biomarkers such as TSH, free tissue triiodothyronine, and free thyroxine were measured.
• Participants completed the Underactive Thyroid-Dependent Quality of Life Questionnaire and Underactive Thyroid Symptom Rating Questionnaire to assess thyroid-dependent QOL and the number of hypothyroidism symptoms; other validated questionnaires were used to measure depressive symptoms and somatosensory amplification.

TAKEAWAY:

• The negative impact of hypothyroidism on QOL was most evident in women and participants with higher BMI, autoimmune thyroiditis, greater somatosensory amplification, more severe depression, and a higher count of hypothyroidism-related symptoms.
• None of the thyroid-specific biomarkers were associated with thyroid-dependent QOL.
• In the final model, significant predictors of thyroid-dependent QOL were somatosensory amplification (P=.srcsrc2), BMI (P=.src21), and depression (P <.srcsrc1).

IN PRACTICE:

“When considered collectively, our findings are consistent with the theory that once TSH is normalized, thyroid-dependent QoL is primarily influenced by unrecognized comorbidities such as obesity, somatic symptom disorder, and depression,” the authors wrote.

SOURCE:

This study was led by Bence Bakos, Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary. It was published online on May 26, 2src25, in BMC Endocrine Disorders.

LIMITATIONS:

Researchers could not establish causality owing to the cross-sectional design of this study.

DISCLOSURES:

This study did not receive any specific grant from any funding agency. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.