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Cited by 54Thyroid Disorders and TreatmentsThyroid and Parathyroid SurgeryThyroid Cancer Diagnosis and Treatment

Inadequate levothyroxine replacement for primary hypothyroidism is associated with poor health-related quality of life-a Brazilian multicentre study

Vigário, Patrícia dos Santos, Vaisman, Fernanda, Coeli, Cláudia Medina, Ward, Laura, Graf, Hans, Carvalho, Gisah, Júnior, Renan Montenegro, Vaisman, Mário·2013·Endocrine
DOI 10.1007/s12020-013-9886-1
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Abstract

This study aimed to verify the impact of levothyroxine replacement on health-related quality of life (HRQoL) in a Brazilian sample of primary hypothyroidism patients. A cross-sectional study was performed with 2,057 consecutive primary hypothyroidism patients on levothyroxine (LT4) replacement at four referral centers in Brazil (median age = 53; 25th percentile = 43; 75th percentile = 61 years). Patient biochemical data were acquired from medical records, and patients completed a questionnaire on socioeconomic issues and clinical signs and symptoms of hypothyroidism. HRQoL was assessed using the SF-36v2. Patients were divided into three groups according to TSH levels: overtreated (OvT; TSH < 0.4 mU/L), appropriately treated (AT; TSH between 0.4 and 4.0 mU/L), and undertreated (UnT; TSH > 4.0 mU/L). Patients were also analyzed by TSH and FT4 serum levels: overt hyperthyroidism (OHyper; TSH < 0.4 mU/L and FT4 > 1.9 ng/dL), subclinical hyperthyroidism (SHyper; TSH < 0.4 mU/L and FT4 0.8-1.9 ng/dL), subclinical hypothyroidism (SHypo; TSH > 4.0 mU/L and FT4 0.8-1.9 ng/dL), and overt hypothyroidism (OHypo; TSH > 4.0 mU/L and FT4 < 0.8 ng/dL). A total of 14.4 % of patients were OvT, with 13.0 % SHyper and 1.4 % OHyper. The prevalence of UnT was 25.9 %, with 21.5 % SHypo and 4.4 % OHypo. Overtreatment was not associated with HRQoL impairment. UnT patients had worse HRQoL than AT patients, especially for physical and emotional aspects, independent of SHypo or OHypo status. Hypothyroidism undertreatment is associated with poor patient HRQoL. Therefore, adequate LT4 therapy should be given to maintain serum TSH within the reference range.

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  • Failure to achieve euthyroidism is linked to higher morbidity and mortality and worse physical and emotional quality of life.

    “Failing to achieve euthyroidism has been associated with increased morbidity and mortality and poorer physical and emotional quality of life, highlighting the need to investigate and address the underlying factors.1,32”

    From Refractory hypothyroidism: unraveling the complexities of diagnosis and management (2023) · cites this paper as [32]

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Authors
Vigário, P. D. S., Vaisman, F., Coeli, C. M., Ward, L., Graf, H., Carvalho, G., Júnior, R. M., & Vaisman, M.
Affiliations
  • Universidade Federal do Rio de Janeiro (BR)
  • Universidade Estadual de Campinas (UNICAMP) (BR)
  • Universidade Federal do Paraná (BR)
Corresponding author
Vigário, Patrícia dos Santos
ORCID
Venue
Endocrine
Publisher
Springer Science and Business Media LLC
Published
2013-01-31
Volume
44
Issue
2
Pages
434-440
ISSN
  • 0969-711X (ISSN-L)
  • 1355-008X
  • 1559-0100
DOI
10.1007/s12020-013-9886-1
OpenAlex
W1993655330
Cited by
54
References
30
Citations by year
2026: 1 · 2025: 2 · 2024: 2 · 2023: 7 · 2022: 10 · 2021: 7 · 2020: 3 · 2019: 8 · 2018: 5 · 2017: 3 · 2015: 3 · 2014: 3
FWCI
1.57
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Endocrine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
Keywords
primary hypothyroidism, levothyroxine replacement, health-related quality of life, overtreatment, undertreatment, thyroid-stimulating hormone, subclinical hypothyroidism, subclinical hyperthyroidism, free thyroxine, SF-36, thyroid hormone replacement
MeSH terms
Adult, Brazil, Cross-Sectional Studies, Health Status, Humans, Hypothyroidism, Middle Aged, Quality of Life, Reference Values, Thyrotropin, Thyroxine, Triiodothyronine, Hormone Replacement Therapy

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