Nontoxic Goiter (NTG) and Radioiodine: What Do Patients Think About It? Quality of Life in Patients with NTG Before and After 131-I Therapy

Abstract

ObjectiveDespite numerous publications regarding nontoxic goiter (NTG) treatment and an increasing interest in patients’ quality of life, few studies present the outcome of 131-I treatment from the patients’ perspective. Our study’s main aim was to verify whether there is any improvement in life quality following 131-I treatment.Materials and methodsThirty-five patients with NTG qualified to participate in the study. All patients completed a Thyroid-Related Health-Related Quality of Life (Thy-R-HRQoL) questionnaire created by us and the Medical Outcomes Study 36-item Short Form (SF-36), right before and 1 year after 131-I.ResultsWe observed an improvement in six out of eight SF-36 and three out of seven Thy-R-HRQoL domains. In comparison with the control group, we observed worse results in two out of eight, prior to treatment, and one out of eight SF-36 afterward, as well as in all Thy-R-HRQoL domains. We did not find any correlation between improvement of Thy-R-HRQoL and SF-36 and goiter size reduction, except for Bodily Pain. There was also no correlation between improvement of SF-36 and Thy-R-HRQoL domains, and goiter size before treatment. The older the patient, the less noticeable improvement was observed in Physical and Social Functioning, and Vitality in SF-36, but age had no influence on the assessment by Thy-R-HRQoL.ConclusionRadioiodine treatment improves life quality in patients with NTG. Use of the Health-Related Quality of Life questionnaire should be taken into consideration when evaluating life quality of patients with NTG. Relentless pursuit of maximal goiter size reduction in 131-I treatment is worth consideration. In our study, life quality improvement did not depend directly on the goiter size reduction. Life quality improvement after 131-I might not depend on initial goiter size, and for certain domains of SF-36 might be less clearly expressed in older patients.

Thyroid disease‐specific quality of life questionnaires ‐ A systematic review

“…The Thy‐R‐HRQoL (Thyroid‐Related Health‐Related Quality of Life) questionnaire was created by Kaniuka‐Jakubowska et al and is suitable for assessing QoL in euthyroid goitre. 29 It consists of a total of 49 questions divided into 7 domains. The answer options range from ‘1 = definitely no’ to ‘6 = definitely yes’.…”

“…The Thy‐D‐QoL could be used in research with hypothyroidism as a focus or in the clinical setting, as it is even shorter than the ThyPRO‐39. For the goitre‐specific questionnaire by Kaniuka‐Jakubowska, the Thy‐R‐HRQoL, validity has not been tested 29 . Nevertheless, it has high reliability and could be used as an additional questionnaire for questions investigating the effects of goitre.…”

“…For the goitre‐specific questionnaire by Kaniuka‐Jakubowska, the Thy‐R‐HRQoL, validity has not been tested. 29 Nevertheless, it has high reliability and could be used as an additional questionnaire for questions investigating the effects of goitre. One advantage is that with a total of 49 items it addresses possible problems caused by goitre very specifically.…”

Thyroid disease in the elderly

“…Více v části subkli nická hypertyreóza. Šetrnou léčbou je podání radiojodu, dopad je nejen na zklidnění subklinické hyper tyreózy a psychiku, ale má i efekt zmenšovací [4]. Recentní práce informují o možnosti zmenšení či likvidace hyperfunkč ních oblastí radiofrekvenční ablací [5].…”

“…Ke konkrétním hodnotám s ohledem na věk se vyjádřila nedávná studie. Vyšetřením zdravých starších téměř 4 000 osob (z toho zcela zdravých 411) stanovili normu TSH 0,64-5,9 mIU/l a fT 4 12,1-20,6 pmol/l. Doporučují pro starší populaci tyto revidované normy respektovat.…”