Muscle mass and function in thyrotoxic patients before and during medical treatment
Open accessAbstract
OBJECTIVE: Development of muscle weakness and atrophy are well known complications of thyrotoxicosis, although little is known about its clinical course. The present longitudinal study was therefore undertaken to monitor muscle mass and strength before and during treatment of hyperthyroidism. DESIGN AND PATIENTS: Five patients (2 male, 3 female; Age 41 ± 6 years; BMI 22.2 ± 1.1 kg/m 2) with newly diagnosed hyperthyroidism were studied with respect to muscle area, muscle strength, body composition and substrate metabolism at baseline and after 1, 3, 6, 9 and 12 months of treatment. MEASUREMENTS: Midthigh muscle areas were assessed by computed tomography (CT), while bioelectrical impedance analysis (BIA) was used for assessment of body composition. The isometric strength of the biceps brachialis and quadriceps muscles was assessed by means of a dynamometer and the maximal static ins‐ and ex‐piratory mouth pressures were measured with a respiratory pressure module. RESULTS: Prior to treatment thyrotoxic patients all displayed elevated levels of total and free T 3 and T 4 together with suppressed TSH. BMI, fat mass and lean body mass increased significantly during the treatment period, while energy expenditure (EE) decreased. Thigh muscle areas increased by 24% (101.5 ± 11.5 vs. 125.3 ± 13.1 cm 2, P < 0.05) from entry to peak. Peak time was 9 ± 0.9 months. During treatment a significant (P < 0.01) increase in muscle strength was observed; arm capacity increased by 48%, while leg capacity increased by 51%. Peak time (months) was: Right arm: 8 ± 3, left arm: 7 ± 2, right leg: 5 ± 3, left leg: 9 ± 2. Respiratory muscle strength, expressed as maximal ins‐ or ex‐piratory mouth pressure, was significantly impaired among patients at entry. A significant increase in inspiratory and expiratory strength was found from entry to peak (P < 0.05), as inspiratory strength increased by 35% and expiratory by 19%. Inspiratory strength peaked after 7 ± 1 months, expiratory muscle strength after 6 ± 1 months. CONCLUSIONS: In conclusion we find that in patients with thyrotoxicosis muscle mass is reduced by approximately 20% and muscle strength by approximately 40% and that between 5 and 9 months elapse before normal muscle mass and function are reestablished.
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With normalisation of thyroid concentrations, muscle mass and strength are re-established, but this can take up to 9 months.
“With normalisation of thyroid concentrations, muscle mass and strength are re-established, but this can take up to 9 months to occur.98”
From Age-related and disease-related muscle loss: The effect of diabetes, obesity, and other diseases (2014) · cites this paper as [98]
In patients with severe thyrotoxicosis, muscle mass can be reduced by up to 20% and muscle strength by 40%.
“Muscle mass can be reduced by up to 20% and muscle strength by 40% in patients with severe thyrotoxicosis.”
From Age-related and disease-related muscle loss: The effect of diabetes, obesity, and other diseases (2014) · cites this paper as [98]
In young or non-elderly subjects, hyperthyroidism is associated with reduced muscle strength.
“few studies in young or non-elderly subjects have demonstrated reduced muscle strength, which is restored after normalization of thyroid hormones (114–119).”
From Levothyroxine therapy in elderly patients with hypothyroidism (2021) · cites this paper as [119]
Muscle strength is restored after normalization of thyroid hormones in young or non-elderly subjects with hyperthyroidism.
“few studies in young or non-elderly subjects have demonstrated reduced muscle strength, which is restored after normalization of thyroid hormones (114–119).”
From Levothyroxine therapy in elderly patients with hypothyroidism (2021) · cites this paper as [119]
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- Authors
- Nørrelund, H., Hove, K. Y., Brems‐Dalgaard, E., Jurik, A. G., Nielsen, L. P., Nielsen, S., Nielsen, S., Jørgensen, J. O. L., Weeke, J., & Møller, N.
- Affiliations
- Aarhus University Hospital (DK)
- Corresponding author
- Nørrelund, Helene
- ORCID
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 1999-12
- Volume
- 51
- Issue
- 6
- Pages
- 693-699
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W1969607279
- Cited by
- 58
- References
- 32
- Citations by year
- 2026: 2 · 2025: 2 · 2023: 4 · 2022: 1 · 2021: 3 · 2020: 2 · 2019: 2 · 2018: 3 · 2016: 2 · 2015: 1 · 2014: 7 · 2013: 1 · 2012: 2
- FWCI
- 0.69
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Novo Nordisk
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Pathology and Forensic Medicine › Ophthalmology and Eye Disorders
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Keywords
- hyperthyroidism, thyrotoxicosis, muscle mass, muscle strength, muscle atrophy, muscle weakness, antithyroid drug therapy, body composition, lean body mass, energy expenditure, respiratory muscle strength, quadriceps, isometric strength, substrate metabolism, TSH suppression
- MeSH terms
- Adult, Analysis of Variance, Body Composition, Calorimetry, Indirect, Female, Humans, Longitudinal Studies, Male, Methimazole, Muscle Contraction, Respiratory Muscles, Thigh, Antithyroid Agents, Thyrotoxicosis, Thyroxine, Body Mass Index, Muscle, Skeletal
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