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Reduced quality of life, persistent symptoms and dissatisfaction in LT4-treated hypothyroid patients: A medical need for improved treatment

  • At: PPR 2022 (2022)
  • Type: Poster
  • Poster code: PT-08
  • By: MOLEWIJK, Ellen (University Of Applied Sciences Utrecht)
  • Co-author(s): Ellen Molewijk, Researcher, University Of Applied Sciences Utrecht, Netherlands
    Eric Fliers, endocrinologist, Amsterdam UMC, location AMC, Netherlands
    Koen Dreijerink, endocrinologist, Amsterdam UMC, location VU, Netherlands
    Ad van Dooren, lector (em)
    Rob Heerdink, lector

  • Abstract:

    Generally, it is believed that standard levothyroxine (LT4) therapy is sufficient to restore euthyroidism and relieve hypothyroid symptoms in hypothyroid patients. However, a considerable proportion of treated patients remains symptomatic despite normal TSH/FT4 serum values.
    Using a digital survey we investigated quality of life (QoL, ThyPRO), daily functioning (SF-36), and hypothyroid-related symptoms in hypothyroid patients and control persons without thyroid diseases. The ThyTSQ was used to measure patient (past and present) satisfaction. Patients and control persons (through snowballing) were recruited through patient organizations, posters/flyers and social media.
    The QoL of hypothyroid patients (n=1,195) was significantly (mean +73%) more disrupted in all domains, as compared to controls (n=240) (p<0.001). TSH, FT4, age, gender and duration of illness did not significantly affect QoL, whereas the M3 comorbidity index (weighted sum of reported comorbidities) did to a minor extent. Hypothyroid patients had significantly (mean 52%) more impairment of daily functioning and reported significantly (mean 2,8 times) higher scores for symptoms related to hypothyroidism, as compared to control persons (all p<0.001). The majority of patients (77.8%) reported not feeling well while their blood values were within the reference range and would like to have a better treatment for hypothyroidism (74.5%, n=1,194). The mean satisfaction score was 3.5 out of 6 (58%). The lowest satisfaction was expressed for the information given about the illness and its treatment, as well as the attitude of the physician, around the time of diagnosis (means 2.5, 2.7, 2.8 resp.).
    In this comprehensive study, hypothyroid patients had a worse QoL, impaired daily functioning and residual hypothyroid-related symptoms, compared to control persons, despite thyroid replacement therapy and serum TSH/FT4 within the target range values. Furthermore, hypothyroid patients expressed dissatisfaction with treatment and care. As such, we see a medical need for better treatment modalities and care in a proportion of hypothyroid patients.

Last update 4 October 2019

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