scholarly journals Thyroidectomy Improves Quality of Life and Fatigue in Patients with Hashimoto's Disease and Persistent Symptoms Compared to Adequate Thyroid Hormone Replacement

2019 ◽  
Vol 31 (5) ◽  
pp. 178-181
Author(s):  
Trevor E. Angell
Keyword(s):  
Quality Of Life ◽  
Thyroid Hormone ◽  
Hormone Replacement ◽  
Thyroid Hormone Replacement ◽  
Persistent Symptoms ◽  
Hashimoto’S Disease ◽  
Hashimoto's Disease

scholarly journals Combination Treatment with T4 and T3: Toward Personalized Replacement Therapy in Hypothyroidism?

2012 ◽  
Vol 97 (7) ◽  
pp. 2256-2271 ◽  
Author(s):  
Bernadette Biondi ◽  
Leonard Wartofsky
Keyword(s):  
Quality Of Life ◽  
Thyroid Hormone ◽  
Replacement Therapy ◽  
Hormone Replacement ◽  
Hormone Action ◽  
Thyroid Hormone Replacement ◽  
Thyroid Hormone Action ◽  
Thyroid Hormone Replacement Therapy ◽  
Hypothyroid Patients

Abstract Context: Levothyroxine therapy is the traditional lifelong replacement therapy for hypothyroid patients. Over the last several years, new evidence has led clinicians to evaluate the option of combined T3 and T4 treatment to improve the quality of life, cognition, and peripheral parameters of thyroid hormone action in hypothyroidism. The aim of this review is to assess the physiological basis and the results of current studies on this topic. Evidence Acquisition: We searched Medline for reports published with the following search terms: hypothyroidism, levothyroxine, triiodothyronine, thyroid, guidelines, treatment, deiodinases, clinical symptoms, quality of life, cognition, mood, depression, body weight, heart rate, cholesterol, bone markers, SHBG, and patient preference for combined therapy. The search was restricted to reports published in English since 1970, but some reports published before 1970 were also incorporated. We supplemented the search with records from personal files and references of relevant articles and textbooks. Parameters analyzed included the rationale for combination treatment, the type of patients to be selected, the optimal T4/T3 ratio, and the potential benefits of this therapy on symptoms of hypothyroidism, quality of life, mood, cognition, and peripheral parameters of thyroid hormone action. Evidence Synthesis: The outcome of our analysis suggests that it may be time to consider a personalized regimen of thyroid hormone replacement therapy in hypothyroid patients. Conclusions: Further prospective randomized controlled studies are needed to clarify this important issue. Innovative formulations of the thyroid hormones will be required to mimic a more perfect thyroid hormone replacement therapy than is currently available.

scholarly journals What Is the Quality of Life in Patients Treated with Levothyroxine for Hypothyroidism and How Are We Measuring It? A Critical, Narrative Review

2021 ◽  
Vol 10 (7) ◽  
pp. 1386
Author(s):  
Françoise Borson-Chazot ◽  
Jean-Louis Terra ◽  
Bernard Goichot ◽  
Philippe Caron
Keyword(s):  
Quality Of Life ◽  
Thyroid Hormone ◽  
Hormone Replacement ◽  
Well Being ◽  
Narrative Review ◽  
Overt Hypothyroidism ◽  
Thyroid Function Tests ◽  
Persistent Symptoms ◽  
Pubmed Database

Thyroid hormone replacement therapy (THRT, generally using oral levothyroxine (LT4)) is a safe, effective means of treating hypothyroidism. However, a proportion of LT4-treated patients with biochemically normal thyroid function tests complain of persistent symptoms that impact their health-related quality of life (QoL). The objectives of this critical, narrative review of the literature were to identify studies of QoL in LT4-treated patients with hypothyroidism, examine the instruments used to measure QoL, determine whether normal QoL is restored by THRT, and identify factors associated with QoL. The PubMed database was searched from 1 January 2000 to 31 December 2020. A total of 809 publications were screened, 129 full-text articles were retrieved, and 58 were analyzed. The studies of overt hypothyroidism evidenced an improvement in psychological and emotional well-being after three to six months of THRT with LT4, although contrasting results were found for patients with subclinical hypothyroidism. Combination treatment with LT4 and liothyronine was not generally associated with better QoL. In hypothyroidism, QoL appears to be influenced by a number of physiological, behavioral, cognitive and/or lifestyle factors that are not strictly related to thyroid hormone levels.

scholarly journals Can Thyroidectomy Improve Quality of Life in Patients With Hashimoto’s Thyroiditis?

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A825-A826
Author(s):  
Summaya A Latif ◽  
Sarah E Robbins ◽  
Cameron MacDonald ◽  
Nadine Connor ◽  
Rebecca S Sippel
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Thyroid Hormone ◽  
Short Form ◽  
Symptom Burden ◽  
Symptom Improvement ◽  
Control Group ◽  
P Value ◽  
Persistent Symptoms

Abstract Introduction: Patients with Hashimoto’s often complain of persistent symptoms despite being on optimal medical therapy. Research suggests that thyroidectomy may have a role in improving this. We investigated the change in Quality of Life (QoL), symptom burden and mental health from baseline to 1 year after total thyroidectomy in patients with underlying thyroiditis. Methods: We conducted semi-structured interviews with 96 patients at baseline and 1 year to discuss their thyroid-related symptom burden. Patients utilized prompt cards to identify and rank the severity of their thyroid-related symptoms (3 being most bothersome and 0 being no effect at all). Individual symptom scores were added to calculate a Cumulative Symptom Score (CSS). Patients also completed the validated Short Form-12 (SF-12) questionnaire for mental and physical health (scored from 0-100; higher score attributing to better health) and ThyCa-QoL questionnaire (scored from 0-100; higher score attributing more complaints) at these 2 time-points. Results: Of the 96 patients with available CSS data, there were 37 patients in the Hashimoto’s group (97% had biopsy proven thyroiditis and 24% were on thyroid hormone at baseline) and 59 patients in the control group. At baseline, Hashimoto’s patients had a higher CSS than the control group (9.94 vs. 7.13, p=0.05). Overall, mean CSS, in both groups, declined from baseline to 1 year (7.74 to 6.08, p=0.04), and over half of the individual patients, had a decline in their CSS at 1 year (56% in Hashimoto’s and 54% in control). Although, the Hashimoto’s group started higher at their baseline, they also had a slightly larger decline in CSS at 1 year than the control patients (-2.2, p=0.11 vs. -1.2, p=0.19). On the SF-12, Hashimoto’s patients had a significant improvement in their mental health (+ 6.0 pts, CI 1.8-10.2, p value = 0.007) whereas the control patients did not (+2.4 pts, CI 0.3-5.2, p=0.08). On the ThyCa-QoL, Hashimoto’s patients had worse scores at baseline as compared to the control patients (20.8 vs 16.7, p=0.11) and there was a slight but clinically significant improvement from baseline to 1 year (decrease in mean of 1.18 pts, p=0.5). Analysis of the qualitative data showed that of the 10 patients who were on thyroid hormone pre-operatively, 9 described significant symptom improvement at 1 year, with fatigue being the major symptom that was reported as improved. Conclusion: Based on the data above, we see that patients with Hashimoto’s do have a higher symptom burden at baseline and thyroidectomy may play a role in symptom alleviation as well as improving mental health and QoL. Our data supports recent findings that thyroidectomy may play a role in alleviating thyroid related symptoms in this patient population and further investigation to better understand this phenomenon is warranted.

scholarly journals SAT-430 Quality of Life After Thyroidectomy for Patients with Hashimoto’s Disease and Persistent Symptoms

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Priyanka Thatipamala ◽  
Julia Noel ◽  
Lisa Orloff
Keyword(s):  
Quality Of Life ◽  
Hashimoto’S Thyroiditis ◽  
General Health ◽  
Hashimoto's Thyroiditis ◽  
Health Score ◽  
Persistent Symptoms ◽  
Sf 36 ◽  
Hashimoto's Disease ◽  
General Health Score

Abstract Objective: To determine whether thyroidectomy improves quality of life in patients with Hashimoto’s thyroiditis with persistent symptoms despite biochemical euthyroidism. Study Design: A retrospective cohort study of patients undergoing thyroidectomy for Hashimoto’s thyroiditis. Setting: Tertiary referral center. Subjects and Methods: Included patients underwent thyroidectomy for Hashimoto’s thyroiditis at our institution between 2014 and 2018. The following variables were collected: age, race, body mass index (BMI), pre-operative symptoms, pre-operative thyroid peroxidase antibody (TPO Ab), thyroglobulin antibody (Tg Ab) thyroid stimulating hormone (TSH), free T4, specimen weight, and presence of thyroiditis or malignancy on the pathology report. The primary outcome was general health score on the Short Form-36 Health Survey (SF-36) ranging from 3–35 months postoperatively. Secondary outcomes included an additional questionnaire specifically addressing disease management after surgery as well as any adverse outcomes. Results: 19 patients were included in the study. 18 of the 19 patients were female with a mean age of 48 years (SD 13.6 years). The majority of patients were Caucasian. There was no significant difference between the general health score of the Hashimoto’s thyroiditis patients post-operatively compared to a healthy control population. (66.9 vs. 74.1; 95% CI [-16.9 + 2.5], p = 0.16). There were also no significant differences between groups within the 7 SF-36 subscores. Elevation in pre-operative TPO Ab correlated with lower reported post-operative energy levels (r = -0.63, p = 0.016) and emotional well-being (r = -.55, p = 0.041). 87.5% (14/16) of respondents reported to be moderately or extremely happy with their decision to proceed with surgery. Conclusions: Quality of life in patients with Hashimoto’s thyroiditis who undergo thyroidectomy is equivalent to the general population, and the majority of patients are satisfied with the decision to have undergone surgery. Thyroidectomy is a consideration for patients with Hashimoto’s disease and persistent symptoms despite optimization on medical therapy.

A Review of Thyroid Hormone Administration during Adult Donor Care

2005 ◽  
Vol 15 (3) ◽  
pp. 202-207 ◽  
Author(s):  
David J. Powner ◽  
Michael Hernandez
Keyword(s):  
Thyroid Hormone ◽  
Organ Procurement ◽  
Hormone Replacement ◽  
Treatment Protocols ◽  
Thyroid Hormone Replacement ◽  
Hormone Administration ◽  
Routine Administration ◽  
Thyroid Hormone Replacement Therapy ◽  
Organ Procurement Organizations

Serum concentrations of thyroid hormones tetraiodothyronine and triiodothyronine commonly are low after head injury and brain death. Thyroid hormone replacement therapy, however, is a controversial part of donor management. This article reviews publications in which thyroid hormone administration was evaluated in human donors. A classification of the “quality” of study methods used in those publications is presented as part of the data review. No publications support the routine administration of thyroid hormone for all donors. “Rescue” replacement in support of cardiac inotropic function is supported by some studies, but the experimental design of those investigations is not optimal. Thyroid hormone replacement and its dosing should be decided by organ procurement organizations as part of treatment protocols.

MENOPAUSAL HORMONOTHERAPY IN ONCOGYNECOLOGIC PATIENTS

2017 ◽  
Vol 63 (6) ◽  
pp. 843-854
Author(s):  
Olga Novikova ◽  
Yelena Ulrikh ◽  
V. Nosov ◽  
A. Charkhifalakyan
Keyword(s):  
Quality Of Life ◽  
Cervical Cancer ◽  
Endometrial Cancer ◽  
Hormone Replacement Therapy ◽  
Hormone Therapy ◽  
Replacement Therapy ◽  
Hormone Replacement ◽  
Menopausal Hormone Therapy ◽  
Oncological Safety

There is presented the review of domestic and foreign references on the conserved oncological safety of the use of menopausal hormone therapy after treatment for endometrial cancer, cervical cancer, borderline and malignant ovarian tumors, various variants of sarcomas of the uterus, vulva and vaginal cancer. To the opinion of the authors the refusal to prescribe menopausal hormone therapy to patients with oncogynecologic diseases in the anamnesis is usually not justified, the category of patients, to whom hormone replacement therapy is contraindicated, is well described and mentioned in the text. In other cases sex hormones can be used to treat menopausal symptoms and improve the quality of life of patients.

Linear modulation of serum thyrotrophin by thyroid hormone treatment in hypothyroidism

1980 ◽  
Vol 95 (4) ◽  
pp. 472-478 ◽  
Author(s):  
A. Eugene Pekary ◽  
Jerome M. Hershman ◽  
Clark T. Sawin
Keyword(s):  
Thyroid Hormone ◽  
Hormone Replacement ◽  
Hormone Treatment ◽  
Significant Negative Correlation ◽  
Thyroid Hormone Replacement ◽  
Basal Serum ◽  
Thyroid Hormone Levels ◽  
Peak Versus ◽  
Hypothyroid Patients ◽  
Serum Tsh

Abstract. Basal serum TSH and the peak TSH response to a 500 μg TRH bolus were measured in 57 euthyroid and in 29 hypothyroid subjects either receiving graded thyroid hormone replacement or acutely removed from full replacement therapy. Serum TSH, total T4 and T3 were determined by sensitive radioimmunoassay methods. The peak versus basal TSH data for hypothyroid patients were linear within individuals. The regression slope of the peak versus basal TSH data for all hypothyroid subjects did not differ significantly from the corresponding slope for all euthyroid subjects. Basal and peak TSH versus T3 and T4 data for hypothyroid patients were also linear within each individual. Moreover, the regression of the basal TSH values averaged over the non-replacement to full replacement state against the TSH versus T3 slope had a significant negative correlation. This trend leads to an array of regression lines which average to the familiar hyperbolic relationship between thyrotrophin and thyroid hormone levels in man.

scholarly journals What’s going on following acute covid-19? Clinical characteristics of patients in an out-patient rehabilitation program

2021 ◽  
pp. 1-12
Author(s):  
Sergiu Albu ◽  
Nicolas Rivas Zozaya ◽  
Narda Murillo ◽  
Alberto Garcia-Molina ◽  
Cristian Andres Figueroa Chacón ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cognitive Impairment ◽  
Acute Infection ◽  
Rehabilitation Program ◽  
Neuropsychological Impairment ◽  
Outpatient Rehabilitation ◽  
Screening Process ◽  
Icu Patients ◽  
Persistent Symptoms

BACKGROUND: Coronavirus disease 2019 (COVID-19) patients present long-lasting physical and neuropsychological impairment, which may require rehabilitation. OBJECTIVES: The current cross-sectional study characterizes post COVID-19 sequelae and persistent symptoms in patients in an outpatient rehabilitation program. METHODS: Thirty patients [16 post-ICU and 14 non-ICU; median age = 54(43.8–62) years; 19 men] presenting sequelae and/or persistent symptoms (>3 months after acute COVID-19) were selected of 41 patients referred for neurorehabilitation. Patients underwent physical, neuropsychological and respiratory evaluation and assessment of impact of fatigue and quality of life. RESULTS: The main reasons for referral to rehabilitation were: fatigue (86.6%), dyspnea (66.7%), subjective cognitive impairment (46.7%) and neurological sequelae (33.3%). Post-ICU patient presented sequelae of critical illness myopathy and polyneuropathy, stroke and encephalopathy and lower forced vital capacity compared to non-ICU patients. Cognitive impairment was found in 63.3% of patients, with a similar profile in both sub-groups. Increased physical fatigue, anxiety and depression and low quality of life were prevalent irrespective of acute COVID-19 severity. CONCLUSIONS: The variability of post COVID-19 physical and neuropsychological impairment requires a complex screening process both in ICU and non-ICU patients. The high impact of persistent symptoms on daily life activities and quality of life, regardless of acute infection severity, indicate need for rehabilitation.

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