Avaliação clínica e da função muscular em pacientes com hipotireoidismo subclínico

Reuters, Vaneska Spinelli; Buescu, Alexandru; Reis, Fabíola Alves Aarão; Almeida, Cloyra; Teixeira, Patricia Fátima dos Santos; Costa, Antônio José Leal; Wagman, Márcia Branco; Ferreira, Márcia Martins; Castro, Claudia Lúcia Barros de

doi:10.1590/s0004-27302006000300016

Cited by 8 publications

(4 citation statements)

References 43 publications

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“…Symptoms and signs of hypothyroidism have been frequently found in sHT patients, as reported by many authors (6-10), including our group (11).…”

Section: Introductionsupporting

confidence: 85%

“…Some authors have described grea ter frequency of neuromuscular symptoms or muscle dysfunction on electromyography in sHT patients (7,9,11,15). Proximal muscle strength seems to be impaired in sHT, and our group previously published a cross-sectional study in which there was greater prevalence of neuromuscular complaints and altered muscle strength in sHT compared with a control group (11).…”

Section: Introductionmentioning

confidence: 75%

“…Although some transversal studies showed greater prevalence of neuromuscular abnormalities in sHT (7,9,11,15), little has been published about the effect of L-T4 substitution on them. To our knowledge, there is no double-blind placebo-controlled trial that evaluated muscle function until the present moment.…”

Section: Discussionmentioning

confidence: 99%

“…There are very few studies that evaluated muscular function in sHT (7,9,11,15), and none included clinical signs and symptoms, psychiatric complaints, and health status in the same study. We believed that some psychological aspects of thyroid hypofunction, when present in sHT, may be influenced by physical findings, as suggested by the association between physical aspects of quality of life, in the SF-36 evaluation, and muscular function, specially IS, in the present study.…”

Section: Discussionmentioning

confidence: 99%

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Effects of subclinical hypothyroidism treatment on psychiatric symptoms, muscular complaints, and quality of life

Reuters

Almeida

Teixeira

et al. 2012

Arq Bras Endocrinol Metab

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Objectives:To evaluate the impact of subclinical hypothyroidism (sHT) treatment on health--related quality of life (QoL), psychiatric symptoms, clinical score, and muscle function. Materials and methods: In this randomized double-blind study, patients were assigned either to treatment (n = 35) or placebo (n = 36). Clinical and psychiatric symptoms were assessed by the Zulewski, Hamilton and Beck scales. QoL was assessed by the SF-36 questionnaire. Assessments of quadriceps (QS) and inspiratory muscle (IS) strength were performed by a chair dynamometer and a manuvacuometer. Results: Treatment improved IS (+11.5 ± 17.2; p = 0.041), as did QoL domains "Pain" and "Role Physical" (+19.7 ± 15.2, 0.039 and +22.1 ± 47.5, p = 0.054; respectively). Clinical and psychiatric symptoms showed similar responses to both interventions. Conclusions: sHT treatment improved IS and physical aspects of QoL, despite no impact in other muscle parameters. Clinical score, psychiatric symptoms, and SF-36 domains, based on mental dimensions of QoL may be more susceptible to "placebo effect" in patients with sHT.Arq Bras Endocrinol Metab. 2012;56(2):128-36 Keywords Anxiety; depression; quality of life; levothyroxine RESUMO Objetivos: Avaliar o impacto do tratamento do hipotireoidismo subclínico (sHT) na qualidade de vida relacionada à saúde (QoL), aos sintomas psiquiátricos, ao escore clínico e à função muscular. Materiais e métodos: Em um ensaio randomizado duplo-cego, pacientes foram randomizados para tratamento (n = 35) ou uso de placebo (n = 36). Sintomas clínicos e psiquiá-tricos foram acessados por meio das escalas de Zulewski, Hamilton e Beck. A QoL foi avaliada pelo questionário SF-36. Medidas da força de quadríceps (QS) e inspiratória (IS) foram obtidas por um dinamômetro de cadeira e um manovacuômetro. Resultados: O tratamento melhorou a IS (+11,5 ± 17,2; p = 0,041), assim como os domínios "Dor" e "Aspectos Físicos" da QoL (+19,7 ± 15,2, 0,039 e +22,1 ± 47,5, p = 0,054, respectivamente). Sintomas clínicos e psiquiátricos demonstraram respostas similares a ambas as formas de intervenção. Conclusões: Tratamento do sHT melhorou IS e aspectos físicos da QoL, apesar de não ter impacto em outros parâmetros musculares. Escore clínico, sintomas psiquiátricos e domínios do SF-36 que focam em dimensões mentais podem ser mais suscetíveis ao "efeito placebo" em pacientes com sHT.

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“…Symptoms and signs of hypothyroidism have been frequently found in sHT patients, as reported by many authors (6-10), including our group (11).…”

Section: Introductionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Effects of subclinical hypothyroidism treatment on psychiatric symptoms, muscular complaints, and quality of life

Reuters

Almeida

Teixeira

et al. 2012

Arq Bras Endocrinol Metab

Self Cite

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Inadequate levothyroxine replacement for primary hypothyroidism is associated with poor health-related quality of life–a Brazilian multicentre study

et al. 2013

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This study aimed to verify the impact of levothyroxine replacement on health-related quality of life (HRQoL) in a Brazilian sample of primary hypothyroidism patients. A cross-sectional study was performed with 2,057 consecutive primary hypothyroidism patients on levothyroxine (LT4) replacement at four referral centers in Brazil (median age = 53; 25th percentile = 43; 75th percentile = 61 years). Patient biochemical data were acquired from medical records, and patients completed a questionnaire on socioeconomic issues and clinical signs and symptoms of hypothyroidism. HRQoL was assessed using the SF-36v2. Patients were divided into three groups according to TSH levels: overtreated (OvT; TSH < 0.4 mU/L), appropriately treated (AT; TSH between 0.4 and 4.0 mU/L), and undertreated (UnT; TSH > 4.0 mU/L). Patients were also analyzed by TSH and FT4 serum levels: overt hyperthyroidism (OHyper; TSH < 0.4 mU/L and FT4 > 1.9 ng/dL), subclinical hyperthyroidism (SHyper; TSH < 0.4 mU/L and FT4 0.8-1.9 ng/dL), subclinical hypothyroidism (SHypo; TSH > 4.0 mU/L and FT4 0.8-1.9 ng/dL), and overt hypothyroidism (OHypo; TSH > 4.0 mU/L and FT4 < 0.8 ng/dL). A total of 14.4 % of patients were OvT, with 13.0 % SHyper and 1.4 % OHyper. The prevalence of UnT was 25.9 %, with 21.5 % SHypo and 4.4 % OHypo. Overtreatment was not associated with HRQoL impairment. UnT patients had worse HRQoL than AT patients, especially for physical and emotional aspects, independent of SHypo or OHypo status. Hypothyroidism undertreatment is associated with poor patient HRQoL. Therefore, adequate LT4 therapy should be given to maintain serum TSH within the reference range.

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Lower extremity mobility limitation and impaired muscle function in women with ulcerative colitis

Zaltman¹,

Braulio²,

Outeiral³

et al. 2014

Journal of Crohn's and Colitis

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Avaliação clínica e da função muscular em pacientes com hipotireoidismo subclínico

Cited by 8 publications

References 43 publications

Effects of subclinical hypothyroidism treatment on psychiatric symptoms, muscular complaints, and quality of life

Effects of subclinical hypothyroidism treatment on psychiatric symptoms, muscular complaints, and quality of life

Inadequate levothyroxine replacement for primary hypothyroidism is associated with poor health-related quality of life–a Brazilian multicentre study

Lower extremity mobility limitation and impaired muscle function in women with ulcerative colitis

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