Health-related quality of life is impaired in untreated autoimmune hypothyroidism and improves after six months of levothyroxine substitution

K. H. Winther, P. Cramon, T. Watt, J. B. Bjorner, O. Ekholm, U. Feldt-Rasmussen, M. Groenvold, Å. K. Rasmussen, L. Hegedus, S. J. Bonnema

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Abstract

Hypothyroidism is often detected, and subsequently treated, due to health-related quality of life (HRQL) considerations. However, disease specific HRQL impairments and changes following thyroid hormone substitution have not previously been assessed with a validated disease specific instrument. Eighty-one patients with autoimmune hypothyroidism answered disease-specific (ThyPRO) and generic (SF-36) HRQL questionnaires before and 6 months after initiation of levothyroxine substitution. ThyPRO consists of 85 items that assess physical, mental, and social domains of functioning and well-being in patients with benign thyroid disorders. The items are summarized in 13 scales. SF-36 consists of 36 items summarized in 8 scales. NormativeThyPRO(n= 739) and SF-36 (n = 6,638) data were collected from representative general population samples. Score differences between patients and the general population and associations between thyroid stimulating hormone (TSH) and HRQL were assessed with multivariate linear regression analyses adjusted for age, gender, comorbidity and educational status. Changes following treatment were analyzed with the paired t-test. All analyses were adjusted for multiple testing (Hochberg method). Prior to treatment, patients' ThyPRO scores were impaired, compared to the general population, on all 9 comparable scales ( p-values <0.0001). The same was observed for 7 of 8 SF-36 scales. ThyPRO scores improved significantly, on 8 of 13 scales during 6 months' levothyroxine substitution. ThyPRO deficits compared to the general population remained only on 1 of 9 comparable scales (i.e. the hypothyroid symptoms scale, p-value <0.0001). SF-36 scores improved significantly on 4 of 8 scales. The greatestHRQL baseline deficit and response to treatment was found in the tiredness (ThyPRO) and vitality (SF-36) scales. No significant associations between TSH and HRQL were found. For untreated autoimmune hypothyroidism, both disease-specific (ThyPRO) and generic (SF-36) HRQL are impaired, but improve significantly after 6 months of levothyroxine substitution. In this population, ThyPRO nearly normalized, while some SF-36 deficits persisted at 6 months.
Original languageEnglish
Article number563
JournalThyroid
Volume25
Issue numberS1
Pages (from-to)A224
Number of pages1
ISSN1050-7256
DOIs
Publication statusPublished - 2015
EventInternational Thyroid Congress - Walt Disney World Swan and Dolphin Resort, Orlando, United States
Duration: 18. Oct 201523. Oct 2015

Conference

ConferenceInternational Thyroid Congress
LocationWalt Disney World Swan and Dolphin Resort
Country/TerritoryUnited States
CityOrlando
Period18/10/201523/10/2015

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