Thyroid dysfunction – weight problems and the psyche: the patients’ perspective

Abstract

Objective To establish the extent to which individuals with thyroid dysfunction consider weight as a problem and the relevance of psychological factors.Design Cross‐sectional study of individuals with thyroid dysfunction.Participants Members of the British Thyroid Foundation.Main outcome measures Two self‐administered questionnaires, tailored for hypothyroid and hyperthyroid patients, respectively, and circulated to all members of the British Thyroid Foundation. These questionnaires specifically targeted views on weight and the experiencing of psychological symptoms.Results Twenty‐five per cent of hypothyroid individuals regained normal body weight on adequate treatment with Thyroxine but 75% did not. Only 19% of subjects had received dietary advice from their doctor. Eighty‐seven per cent of hypothyroid individuals felt depressed prediagnosis and 80% remained so on adequate treatment. Thirty‐nine per cent felt weight was a contributing factor. Fifty‐five per cent of thyrotoxic subjects reported a weight problem on or after treatment, 69% exceeding their pretoxic weight. Only 28% had received dietary advice from their doctor.Seventy‐eight per cent of thyrotoxic individuals reported mood problems when the thyroid was over active and of these 77% improved with therapy. Twenty‐three per cent did not. In excess of 60% of individuals had persistent symptoms after treatment. Thirty‐four per cent of these blamed a weight problem.Conclusion Weight is a major concern to the majority of patients with thyroid dysfunction, sometimes contributing to significant mood disturbance. All patients with thyroid dysfunction, particularly if over weight, should receive dietary advice. This must emphasize that thyroid hormone manipulation does not always solve the problem. Furthermore, the associated psychological problems of thyroid disease do not always settle with treatment to euthyroidism and may require therapy in their own right.