ETA2022 Oral Presentations Oral Session 6: Hypothyroidism (5 abstracts)
1Aalborg University Hospital, Dept. of Endocrinology, Aalborg, Aalborg, Denmark; 2Dept Of Endocrinology, Aalborg Universityhospital, Dept. of Endocrinology, Aalborg, Denmark; 3Bispebjerg University Hospital, Endocrinological Dept, Copenhagen, Denmark; 4Department of Endocrinology, Bispebjerg University Hospital, Copenhagen, Denmarkl, Copenhagen, Denmark; 5Research Centre for Prevention and Health, Centre for Health, The Capital Region of Denmark, Glostrup, Denmark, Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark, Glostrup, Denmark; 6Department of Internal Medicine, Slagelse Hospital, Slagelse, Denmark, Slagelse, Denmark; 7National Food Institute, Technical University of Denmark, Copenhagen, Denmark, Copenhagen, Denmark; 8Dept. Of Medicine and Endocrinology, Medicinerhuset, Mølleparkvej Aalborg, Aalborg, Denmark
Background: Few studies have scrutinized the spectrum of symptoms in subclinical hypothyroidism.
Methods: From three DanThyr cross-sectional surveys performed in the period 1997 to 2005, a total of 8,903 volunteers participated in a comprehensive investigation including blood samples and questionnaires on previous diseases, smoking habits, alcohol intake, and education. From the three surveys we included patients with unknown subclinical hypothyroidism (n=376) and euthyroid controls (n=7,619). For further comparison we also added patients newly diagnosed with autoimmune overt hypothyroidism (n=140) recruited from a previous study. We explored to which extent patients with subclinical hypothyroidism reported 13 previously identified hypothyroidism-associated symptoms (tiredness, dry skin, mood lability, constipation, palpitations, restlessness, shortness of breath, wheezing, globulus sensation, difficulty swallowing, hair loss, dizziness/vertigo, and anterior neck pain). In various uni- and multivariate regression models we searched for circumstances predicting why some patients have more complaints than others.
Results: Subclinically hypothyroid patients did not report higher hypothyroidism score ((median, IQR), 2 (0-4) vs. 2 (0-4), P=0.25) compared to euthyroid controls. Within the group of subclinical hypothyroid patients: co-morbidity had the highest impact on symptoms (tiredness, shortness of breath, wheezing; all P<0.001); TSH level had no impact on symptom score; low age was accompanied with higher mental burden (tiredness, P<0.001; mood lability, P<0.001; restlessness, P=0.012), whereas shortness of breath was associated with high BMI (P<0.001) and smoking (P=0.007).
Conclusion: Patients with a thyroid function test suggesting subclinical hypothyroidism do not express thyroid disease related symptoms more often than euthyroid subjects. In subclinical hypothyroidism, clinicians should focus on undiagnosed co-morbidity and should optimize treatment of known concomitant diseases rather than expecting symptomatic relief following levo-thyroxine substitution.