Correlation between TSH levels and quality of life among subjects with well-controlled primary hypothyroidism
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ORIGINAL ARTICLE
Correlation between TSH levels and quality of life among subjects with well-controlled primary hypothyroidism Marta Morón-Díaz1 Pedro Saavedra2 María P. Alberiche-Ruano3,4 Carlos A. Rodríguez-Pérez3 Yaiza López-Plasencia3 Dunia Marrero-Arencibia3 Ana M. González-Lleó3,4 Mauro Boronat 3,4 ●
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Received: 26 April 2020 / Accepted: 30 July 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose It has been suggested that increasing levothyroxine dose to lower TSH levels within the normal laboratory range might be a therapeutic option for patients with apparently well-controlled primary hypothyroidism who are dissatisfied with their treatment and complain of physical or psychological symptoms. This study assessed whether there is a relationship between TSH levels and health-related quality of life (HRQoL) among subjects with adequately treated hypothyroidism. Methods HRQoL was measured with the specific thyroid disease ThyPRO-39 questionnaire in 218 consecutive patients with primary hypothyroidism of any cause attending an Endocrinology Department in a single center. Patients had TSH values within the normal laboratory range on a blood test performed not before than 6 weeks prior to study participation, but they were not aware of their lab results. The association between TSH values and the different ThyPRO-39 scales was analyzed by means of multiple regression models, both linear and additive, in which, in addition to TSH, a wide set of clinical and sociodemographic variables potentially related to HRQoL were also considered. Results TSH levels and the use of anxiolytic and antidepressant drugs were the only variables that showed a positive linear correlation with the ThyPRO-39 composite scale in the multivariate regression analysis, indicating greater impairment in HRQoL with increasing TSH values. TSH was also independently correlated to scores of scales dealing on tiredness and emotional susceptibility. Conclusions In patients with primary hypothyroidism, higher TSH values, even within the normal reference range, are associated with greater deterioration of HRQoL. Keywords Hypothyroidism Quality of life Patient-reported outcome Levothyroxine TSH ●
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Introduction Supplementary information The online version of this article (https:// doi.org/10.1007/s12020-020-02449-4) contains supplementary material, which is available to authorized users. * Mauro Boronat [email protected] 1
Endocrinology and Nutrition, Quirónsalud Tenerife, Santa Cruz de Tenerife, Spain
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Department of Mathematics, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
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Section of Endocrinology and Nutrition, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de Gran Canaria, Spain
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Research Institute in Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
Primary hypothyroidism is a common endocrine disease. According to a recent
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