Association between chronic widespread musculoskeletal complaints and thyroid autoimmunity: Results from a community survey

Aarflot, T.; Bruusgaard, Dag

doi:10.3109/02813439608997080

Cited by 22 publications

(9 citation statements)

References 13 publications

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“…For example, Bazzichi et al [22] found comorbidity with and higher levels of symptoms of fibromyalgia in patients with Hashimoto’s thyroiditis and subclinical hypothyroidism, in contrast to patients with nonautoimmune subclinical hypothyroidism. Additionally, in a population-based study, a higher prevalence of TPOAb positivity was found in respondents with musculoskeletal complaints, compared to those without [24]. An interesting study supposed a possible mechanism of action: Marquez et al [25] found microvascular alterations similar to those observed in other autoimmune diseases in skeletal muscle from patients with autoimmune thyroiditis, independent of thyroid function.…”

Section: Discussionmentioning

confidence: 94%

Is Thyroid Autoimmunity per se a Determinant of Quality of Life in Patients with Autoimmune Hypothyroidism?

et al. 2012

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Purpose: To evaluate the relationship between thyroid variables and health-related quality of life (QoL) in patients with autoimmune hypothyroidism, using the thyroid-specific QoL questionnaire ThyPRO. Methods: In a cross-sectional study, responses to the ThyPRO from 199 outpatients with autoimmune hypothyroidism were analyzed in relation to thyroid volume, thyroid function and markers of thyroid autoimmunity. Based on a classical QoL framework, we hypothesized that physiological dysfunction caused specific physical and psychological symptoms, which affected functioning and well-being, and consequently participation in life and QoL. These hypotheses were tested through multiple regression and multivariate path analysis models. Results: None of the thyroid function tests were associated with QoL scores. However, in the pairwise regression, the thyroid peroxidase antibody (TPOAb) level was associated with several QoL outcomes: Goitre Symptoms (p = 0.024), Depressivity (p = 0.004), Anxiety (p = 0.004), Emotional Susceptibility (p = 0.005) and Impaired Social Life (p = 0.047). In the multivariate model, the TPOAb level was related to Goitre Symptoms (r = 0.17, p = 0.019), Depressivity (r = 0.24, p = 0.001), and Anxiety (r = 0.23, p = 0.002), but no longer to Emotional Susceptibility or Impaired Social Life, indicating that the effect on these were mediated through an effect on the symptom scales (i.e. Goitre Symptoms, Depressivity and Anxiety). Conclusion: Health-related QoL, evaluated with state-of-the-art QoL methodology, was related to TPOAb level but not to thyroid function. This raises the hypothesis that autoimmunity, independent of thyroid function, impacts on QoL in patients with autoimmune hypothyroidism, especially in terms of psychological symptoms. Longitudinal studies, in initially untreated patients, are needed to test this hypothesis.

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Section: Discussionmentioning

confidence: 94%

Is Thyroid Autoimmunity per se a Determinant of Quality of Life in Patients with Autoimmune Hypothyroidism?

et al. 2012

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“…If headache reduces TSH, lower TSH may also be anticipated in other patient groups with pain. However, no difference in TSH was detected between persons with and without chronic musculoskeletal complaints in a Norwegian community survey (Aarflot and Bruusgaard, 1996), but few other epidemiological studies have measured TSH in pain patients.…”

Section: Discussionmentioning

confidence: 99%

Low headache prevalence amongst women with high TSH values

Hagen

Bjøro

Zwart

et al. 2001

Euro J of Neurology

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The aim of this large cross-sectional population-based study was to examine a possible positive or negative association between thyroid dysfunction and headache. Between 1995 and 1997, all 92 566 adults in Nord-Trøndelag County in Norway were invited to participate in a health survey. A total of 51 383 (56%) responded to a headache questionnaire, whereof thyroid-stimulating hormone (TSH) was measured in 28 058 individuals. These included 15 465 women and 8019 men above 40 years of age, 1767 randomly selected individuals between 20 and 40 years of age, and 2807 (97%) with thyroid dysfunction. Associations between thyroid dysfunction and headache were assessed in multivariate analyses, estimating prevalence odds ratios (OR) with 95% confidence intervals (CIs). High TSH values were associated with low prevalence of headache. This was most evident amongst women with no history of thyroid dysfunction. Amongst these, headache was less probable (OR=0.5, 95% CI 0.3-0.7) if TSH > or = 10 mU/l than in women with normal TSH (0.2-4 mU/l). In all age groups between 40 and 80 years, TSH was lower amongst headache sufferers, especially migraineurs, than in those without headache complaints.

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“…The prevalence of autoantibodies is higher in patients with neuromuscular complaints than in patients without neuromuscular complaints 7. In contrast, there is no significant relationship between thyroid function or the presence of thyroid autoantibodies in patients with either Dupuytren's contracture or limited joint mobility 8.…”

Section: Introductionmentioning

confidence: 89%

Autosomal‐dominant non‐autoimmune hyperthyroidism presenting with neuromuscular symptoms

Elgadi

Arvidsson²,

Janson

et al. 2005

Acta Paediatrica

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Aim: Neuromuscular presentations are common in thyroid disease, although the mechanism is unclear. In the present study, we investigated the pathogenesis in a boy with autosomal‐dominant hyperthyroidism presenting with neuromuscular symptoms. Methods: The TSHr gene was investigated by direct sequencing. Functional properties of the mutant TSHr were investigated during transient expression in COS‐7 cells. Family members were investigated by clinical and biochemical examinations. Results: Sequence analysis revealed a previously reported heterozygous missense mutation Glycine 431 for Serine in the first transmembrane segment, leading to an increased specific constitutive activity. Three additional affected family members carried the same mutation. There was no indication of autoimmune disorder. All symptoms disappeared upon treatment with thacapzol and L‐thyroxine and subsequent subtotal thyroidectomy. Conclusion: The data imply that neuromuscular symptoms can be caused by excessive thyroid hormone levels rather than by autoimmunity.

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Association between chronic widespread musculoskeletal complaints and thyroid autoimmunity: Results from a community survey

Cited by 22 publications

References 13 publications

Is Thyroid Autoimmunity per se a Determinant of Quality of Life in Patients with Autoimmune Hypothyroidism?

Is Thyroid Autoimmunity per se a Determinant of Quality of Life in Patients with Autoimmune Hypothyroidism?

Low headache prevalence amongst women with high TSH values

Autosomal‐dominant non‐autoimmune hyperthyroidism presenting with neuromuscular symptoms

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