What Is the Quality of Life in Patients Treated with Levothyroxine for Hypothyroidism and How Are We Measuring It? A Critical, Narrative Review

Borson‐Chazot, Françoise; Terra, Jean‐Louis; Goichot, B.; Caron, Philippe

doi:10.3390/jcm10071386

Cited by 15 publications

(12 citation statements)

References 107 publications

(194 reference statements)

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“…Poor quality of life (QoL) in patients treated with thyroid hormones has been highlighted (5 , 6, 7). Randomised controlled trials have not demonstrated improvement in QoL in patients treated with combination of LT4+LT3 (5) and therefore many other parameters (behavioral, cognitive and/or lifestyle factors) may be relevant (5,8).…”

Section: Introductionmentioning

confidence: 99%

Real-life practice of thyroid hormone use in hypothyroid and euthyroid patients: A detailed view from the THESIS questionnaire survey in France

Buffet

Belin

Attanasio

et al. 2022

Annales d'Endocrinologie

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Section: Introductionmentioning

confidence: 99%

Real-life practice of thyroid hormone use in hypothyroid and euthyroid patients: A detailed view from the THESIS questionnaire survey in France

Buffet

Belin

Attanasio

et al. 2022

Annales d'Endocrinologie

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“…In our study, we demonstrated significant complaints of hypothyroidism in our patients even though they were biochemically euthyroid. In recent years new studies from functional and integrative medicine specialist suggest combined FT3 and FT4 therapy for the treatment of hypothyroidism (24,25) The shortcomings of our study were the small study group size and the absence of a group of patients who were treated with combination treatment of T3/T4 to compare the effects of both treatments. We will be planning a prospective study to evaluate the effects of different treatment models.…”

Section: Discussionmentioning

confidence: 99%

Thyroid Hormone Replacement in Total Thyroidectomized Patients: Symptomatic and Metabolic Effects of Levothyroxine Monotherapy

Akdeniz

Öztop²

2021

Journal of Basic and Clinical Health Sciences

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In this study, we planned to investigate the effects of L-thyroxine monotherapy on total thyroidectomized patients. The main goal of our study is to evaluate if FT4 therapy is good enough not only to maintain euthyroidism but also to provide a good quality of life and a balance in their metabolism Methods: In this study, we retrospectively evaluated 30 total thyroidectomized patients without malignancy. We compared their thyroid hormone levels, glucose metabolism, lipid metabolism, their body mass indexes, and their symptoms of thyroid problems before surgery and after one year of treatment of L-thyroxine monotherapy.Results: the pre-op and post-op thyroid hormone levels were both in the normal range but the FT4 levels were significantly higher in the 1st year results than pre-op results (1,42 ± 0,18 vs 1,29 ± 0,49 respectively P=0,005*) The FT3 levels also were in the normal range in pre and 1st year post-op but post-op FT3 levels were significantly lower than pre-op levels (2,25 ± 0,27 vs 2,92 ± 0,49 retrospectively P<0,001*). The pre-op and postop TSH levels were euthyroid and not statistically significant. The patients tended to gain weight and it seems to be because of a tendency of being insulin resistant. (HOMA-IR pre-op and post-op were 2,2 ± 1,1 vs 2,6 ± 1,1 P<0,01 retrospectively; pre-op and post-op weights were 69,8 ± 9,5 vs 71,1 ± 10,3 P=0,006* respectively). Even all of them were euthyroid the patients tended to feel hypothyroidism symptoms. Conclusion:This study demonstrates that even though they are euthyroid with FT4 treatment total thyroidectomized patients may suffer from hypothyroidism signs and symptoms and metabolic deterioration may occur in such patients. We recommend that we should aim not only to normalize s-TSH levels but also to normalize patients' metabolic parameters and improve the quality of daily life when regulating our treatments.

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“…How do QoL scores of treated subjects compare to controls without hypothyroidism? Numerous randomized and observational studies have included QoL measures as primary or secondary outcomes in patients with treated clinical and subclinical hypothyroidism ( 75 ), with many utilizing ThyPRO as a primary or secondary outcome measure ( 22 , 64 , 76 – 80 ). Overall, the body of literature is quite heterogeneous (e.g., population demographics, etiology of hypothyroidism), and many compare different types of treatment or treatment versus no treatment in the case of subclinical hypothyroidism.…”

Section: Patient-reported Outcomesmentioning

confidence: 99%

Evaluating health outcomes in the treatment of hypothyroidism

Ettleson

Papaleontiou

2022

Front. Endocrinol.

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Clinical hypothyroidism is defined by the inadequate production of thyroid hormone from the thyroid gland to maintain normal organ system functions. For nearly all patients with clinical hypothyroidism, lifelong treatment with thyroid hormone replacement is required. The primary goal of treatment is to provide the appropriate daily dose of thyroid hormone to restore normal thyroid function for each individual patient. In current clinical practice, normalization of thyrotropin (TSH) level is the primary measure of effectiveness of treatment, however the use of a single biomarker to define adequate thyroid hormone replacement is being reevaluated. The assessment of clinical health outcomes and patient-reported outcomes (PROs), often within the context of intensity of treatment as defined by thyroid function tests (i.e., undertreatment, appropriate treatment, or overtreatment), may play a role in evaluating the effectiveness of treatment. The purpose of this narrative review is to summarize the prominent health outcomes literature in patients with treated hypothyroidism. To date, overall mortality, cardiovascular morbidity and mortality, bone health and cognitive function have been evaluated as endpoints in clinical outcomes studies in patients with treated hypothyroidism. More recent investigations have sought to establish the relationships between these end results and thyroid function during the treatment course. In addition to clinical event outcomes, patient-reported quality of life (QoL) has also been considered in the assessment of adequacy of hypothyroidism treatment. From a health care quality perspective, treatment of hypothyroidism should be evaluated not just on its effectiveness for the individual patients but also to the extent to which patients of different sociodemographic groups are treated equally. Ultimately, more research is needed to explore differences in health outcomes between different sociodemographic groups with hypothyroidism. Future prospective studies of treated hypothyroidism that integrate biochemical testing, PROs, and end result clinical outcomes could provide a more complete picture into the effectiveness of treatment of hypothyroidism.

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What Is the Quality of Life in Patients Treated with Levothyroxine for Hypothyroidism and How Are We Measuring It? A Critical, Narrative Review

Cited by 15 publications

References 107 publications

Real-life practice of thyroid hormone use in hypothyroid and euthyroid patients: A detailed view from the THESIS questionnaire survey in France

Real-life practice of thyroid hormone use in hypothyroid and euthyroid patients: A detailed view from the THESIS questionnaire survey in France

Thyroid Hormone Replacement in Total Thyroidectomized Patients: Symptomatic and Metabolic Effects of Levothyroxine Monotherapy

Evaluating health outcomes in the treatment of hypothyroidism

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