Optimal levothyroxine replacement adequately improves symptoms of hypothyroidism; Residual symptoms need further evaluation for other than hypothyroidism causation

Objectives: Many patients with hypothyroidism complain of persistent residual symptoms, despite optimal treatment, although the similar prevalence is seen in patients with documented absence of thyroid disorder in primary health-care setup. We aimed to investigate symptomatic relief in new cases of...

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Main Authors: Rekha Singh, Ashwani Tandon, Sushil Kumar Gupta, K Saroja
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2017-01-01
Series:Indian Journal of Endocrinology and Metabolism
Subjects:
Online Access:http://www.ijem.in/article.asp?issn=2230-8210;year=2017;volume=21;issue=6;spage=830;epage=835;aulast=Singh
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spelling doaj-96ee2904941245dfb0e35f79d51be68d2020-11-24T23:26:34ZengWolters Kluwer Medknow PublicationsIndian Journal of Endocrinology and Metabolism2230-82102017-01-0121683083510.4103/ijem.IJEM_165_17Optimal levothyroxine replacement adequately improves symptoms of hypothyroidism; Residual symptoms need further evaluation for other than hypothyroidism causationRekha SinghAshwani TandonSushil Kumar GuptaK SarojaObjectives: Many patients with hypothyroidism complain of persistent residual symptoms, despite optimal treatment, although the similar prevalence is seen in patients with documented absence of thyroid disorder in primary health-care setup. We aimed to investigate symptomatic relief in new cases of primary hypothyroidism and compare with controls with other chronic conditions. Methods: This prospective case–control follow-up study enrolled patients from July 2014 to May 2015 in an endocrine outpatient clinic of a tertiary hospital. Controls were age- and gender-matched ambulatory individuals with well-controlled other chronic diseases and no major comorbidity. Thyroid symptom questionnaire (TSQ) was administered at pretreatment to all the cases and then they were started on levothyroxine (LT). At euthyroidism, TSQ was readministered. For controls, TSQ was administered only once. TSQ was measured on Likert scale 1-4 for lack of energy, dry skin, constipation, aches and pains, cold intolerance, poor memory, depression, weight gain, tiredness after walking, and difficulty in getting up (DGU). P < 0.05 was considered statistically significant. Results: A total of 194 cases (147 females and 47 males) and 259 controls (187 females and 72 males) were analyzed. A significant difference in the symptoms prevalence was seen between controls and pretreatment cases, except for DGU, and between subclinical and overt hypothyroidism. Pretreatment serum thyroid-stimulating hormone in cases correlated significantly with all their pretreatment symptoms score. All symptoms prevalence decreased significantly posttreatment. At euthyroidism, the mean symptoms score in posttreatment cases was similar or lower than the controls. Conclusion: LT effectively improves the symptoms of hypothyroidism in newly diagnosed cases of primary hypothyroidism. The residual symptoms need an alternation explanation other than hypothyroidism.http://www.ijem.in/article.asp?issn=2230-8210;year=2017;volume=21;issue=6;spage=830;epage=835;aulast=SinghHypothyroidismlevothyroxinesymptomatic relief
collection DOAJ
language English
format Article
sources DOAJ
author Rekha Singh
Ashwani Tandon
Sushil Kumar Gupta
K Saroja
spellingShingle Rekha Singh
Ashwani Tandon
Sushil Kumar Gupta
K Saroja
Optimal levothyroxine replacement adequately improves symptoms of hypothyroidism; Residual symptoms need further evaluation for other than hypothyroidism causation
Indian Journal of Endocrinology and Metabolism
Hypothyroidism
levothyroxine
symptomatic relief
author_facet Rekha Singh
Ashwani Tandon
Sushil Kumar Gupta
K Saroja
author_sort Rekha Singh
title Optimal levothyroxine replacement adequately improves symptoms of hypothyroidism; Residual symptoms need further evaluation for other than hypothyroidism causation
title_short Optimal levothyroxine replacement adequately improves symptoms of hypothyroidism; Residual symptoms need further evaluation for other than hypothyroidism causation
title_full Optimal levothyroxine replacement adequately improves symptoms of hypothyroidism; Residual symptoms need further evaluation for other than hypothyroidism causation
title_fullStr Optimal levothyroxine replacement adequately improves symptoms of hypothyroidism; Residual symptoms need further evaluation for other than hypothyroidism causation
title_full_unstemmed Optimal levothyroxine replacement adequately improves symptoms of hypothyroidism; Residual symptoms need further evaluation for other than hypothyroidism causation
title_sort optimal levothyroxine replacement adequately improves symptoms of hypothyroidism; residual symptoms need further evaluation for other than hypothyroidism causation
publisher Wolters Kluwer Medknow Publications
series Indian Journal of Endocrinology and Metabolism
issn 2230-8210
publishDate 2017-01-01
description Objectives: Many patients with hypothyroidism complain of persistent residual symptoms, despite optimal treatment, although the similar prevalence is seen in patients with documented absence of thyroid disorder in primary health-care setup. We aimed to investigate symptomatic relief in new cases of primary hypothyroidism and compare with controls with other chronic conditions. Methods: This prospective case–control follow-up study enrolled patients from July 2014 to May 2015 in an endocrine outpatient clinic of a tertiary hospital. Controls were age- and gender-matched ambulatory individuals with well-controlled other chronic diseases and no major comorbidity. Thyroid symptom questionnaire (TSQ) was administered at pretreatment to all the cases and then they were started on levothyroxine (LT). At euthyroidism, TSQ was readministered. For controls, TSQ was administered only once. TSQ was measured on Likert scale 1-4 for lack of energy, dry skin, constipation, aches and pains, cold intolerance, poor memory, depression, weight gain, tiredness after walking, and difficulty in getting up (DGU). P < 0.05 was considered statistically significant. Results: A total of 194 cases (147 females and 47 males) and 259 controls (187 females and 72 males) were analyzed. A significant difference in the symptoms prevalence was seen between controls and pretreatment cases, except for DGU, and between subclinical and overt hypothyroidism. Pretreatment serum thyroid-stimulating hormone in cases correlated significantly with all their pretreatment symptoms score. All symptoms prevalence decreased significantly posttreatment. At euthyroidism, the mean symptoms score in posttreatment cases was similar or lower than the controls. Conclusion: LT effectively improves the symptoms of hypothyroidism in newly diagnosed cases of primary hypothyroidism. The residual symptoms need an alternation explanation other than hypothyroidism.
topic Hypothyroidism
levothyroxine
symptomatic relief
url http://www.ijem.in/article.asp?issn=2230-8210;year=2017;volume=21;issue=6;spage=830;epage=835;aulast=Singh
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