Endocrine Abstracts (2013) 32 P999 | DOI: 10.1530/endoabs.32.P999

Short-term effects of thyroid hormone therapy on quality-of-life evaluation by ThyPRO questionnaire in chronic autoimmune thyroiditis

Marilena Sidoti1 & Massimo Giusti1,2

1Centro Diagnostico Priamar, Savona, Italy; 2Dipartimento di Medicina Interna, Università di Genova, Genoa, Italy.

In chronic autoimmune thyroiditis, increased TPOAb levels have been found to be associated with impaired quality-of-life (QoL). Aim of the study was to evaluate QoL by means of ThyPRO in women with positive TPOAb levels. From January to December 2011, 62 women were invited to the study. Inclusion criteria were: age >18 years, TPOAb >100 mIU/l, no previous therapy for thyroid, no current wish to become pregnant and availability of an E-mail address. Women were randomized to observation (Gr 1 n=21), L-T4 (Gr 2 n=21; 50 μg/day) or L-T4+T3 (Gr 3 n=20; 37 μg+10.7 μg/day). Clinical parameters, symptoms, current therapies and laboratory parameters were recorded. Women were asked to compile and send in ThyPRO at the baseline and 1 and 6 months after. No differences among groups noted with regard to age and clinical and laboratory parameters. At the baseline TSH >4.2 mIU/l was found in 62, 81, and 80% in Gr 1, Gr 2, and Gr 3. No differences in symptoms or drug load were noted at the baseline, but asthenia was more frequent in Gr 3 (45%) than in Gr 1 (24%) and Gr 2 (9%) (P=0.03). No difference in psychological symptoms (Gr 1 19%, Gr 2 33%, Gr 3 40%; P=0.3) or therapies (Gr 1–3 1–2%) was found. The study was completed by 71, 57, and 60% of Gr 1, Gr 2, and Gr 3 women. At the baseline, no difference in ThyPRO scores emerged. Only systolic BP was significantly (P=0.02) related to the mean ThyPRO score. A decrease in TSH levels was noted in Gr 2 (P=0.001) and Gr 3 (P=0.01). QoL improved but, the decrease in mean ThyPRO scores (i.e. fewer symptoms or lower impact of disease) was only slightly significant in Gr 1 (18.1±1.8 vs 15.7±2.2; P=0.02), while it was highly significant (P=0.0005) in Gr 2 (30.1±4.9 vs 20.3±3.9) and Gr 3 (26.1±3.5 vs 16.7±2.6). At the last examination, a significant difference was found in % of symptomatic patients among the groups (Gr 1 33%, Gr 2 42%, Gr 3 83%; P=0.02). At the baseline, the scale Tiredness displayed the highest scores; at the last examination, an improvement was noted, but this was significant only in Gr 3 (P=0.03). Although further studies in larger populations are needed, our data do not confirm a correlation between QoL and TPOAb levels in autoimmune thyroiditis. A significant improvement in QoL was seen and this was more significant under thyroid hormone supplementation. The differences between L-T4 therapy and L-T4+T3 therapy proved slight.

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