Posttreatment symptoms in hypothyroidism and correlations with thyroid-stimulating hormone and free triiodothyronine and free thyroxine: A ThyPRO-based follow-up study

Abstract

ABSTRACT Background: Treatment of primary hypothyroidism with levothyroxine does not fully alleviate its symptoms. Though there have studies to correlate levels of tri-iodothyronine with symptomatology, its role still remains controversial. Aims: To study symptoms of hypothyroidism before and after levo-thyroxine therapy using ThyPRO 39 scores and to correlate these with thyroid hormone levels. Materials and Methods: This quasi-experimental study was conducted at the in and outpatients' departments of Internal Medicine and Endocrinology of St John's Medical College Hospital. Patients were enrolled if they were aged over 18 years and were diagnosed with hypothyroidism (TSH>/= 10 IU/l). Pregnant ladies and patients who had undergone radioiodine therapy or were diagnosed with thyroid cancers were excluded. Results: A total of 46 (F=28) patients were enrolled into the study. The mean age of the study group was 41.63 +/-SD 12.078 years.Among hypothyroid symptoms at diagnosis, Tiredness and Emotional Susceptibility had the highest effect size. Tiredness, Cognitive complaints and Depressive symptoms had significant negative correlation with fT3.While Goitre, Tiredness, and Cognitive complaints showed significant association with TSH, no correlations were noted with fT4 and many scores. There was a statistically significant negative correlation between fT3 and post therapy domain scores of Goitre, Tiredness, Impaired Daily Life and Impaired Social Life. There was a significant difference in the QoL domain between those with and without co-morbidities, the latter group having lower scores signifying better QoL. Conclusion: Symptoms of hypothyroidism may have a correlation with fT3 levels. Larger well-designed studies with supplementation of T3(triiodothyronine) and correlation with symptoms and tissue levels of fT3 will give conclusive answers.