Thyroid Research Thyroid Research Archive Hypothyroidism

Adequately treated patients with hypothyroidism feel less well than other patients

(March 2003)

The background of the study. Some patients with hypothyroidism do not feel well despite adequate treatment with thyroxine (T4), as determined by measurements of serum thyrotropin (TSH). In this study the well-being of a large number of patients with hypothyroidism treated with T4 was assessed.

How the study was done. The study subjects were 961 adults who had been taking T4 for at least four months. These patients and 961 age- and sex-matched patients not taking T4 were sent a three-part questionnaire. One part consisted of questions about medical conditions, the second part questions about psychological well-being, and the third part questions about symptoms of thyroid dysfunction. Possible responses to the questions about well-being ranged from better than usual (low score) to much less than usual (high score). The responses to the thyroid questionnaire ranged from symptom absent to symptom present; higher scores indicated lesser well-being or more thyroid symptoms.

The results of the study. Questionnaires were returned by 597 patients (62 percent) in the T4-therapy group and 551 patients (57 percent) in the control group. The respondents in the T4-therapy and control groups were 60 and 59 years old, respectively; 85 and 87 percent, respectively, were women. The frequency of diabetes, cardiovascular disease, hypertension, and depression was higher in the T4-therapy group than in the control group.

The patients taking T4 scored slightly higher on both the psychological well-being questionnaire and the thyroid-symptom questionnaire, as compared with the control group. The results were similar in the patients taking T4 who had had a normal or abnormal serum TSH concentration in the past year.

The conclusions of the study. Patients with hypothyroidism receiving adequate T4 therapy do not feel as well as other patients of the same age and sex.

The original article. Saravanan P, Chau WF, Roberts N. Vedhara K, Greenwood R, Dayan CM. Psychological well-being in patients on 'adequate' doses of L-thyroxine: results of a large, controlled community-based questionnaire study. Clin Endocrinol 2002;57:577-85.