Hyperthyroid Myopathy and the Response to Treatment
Abstract
Hyperthyroidism is accompanied by significant dysfunction of both proximal and distal skeletal muscles. The purpose of this study was to quantitate the degree of muscle weakness in newly diagnosed patients with Graves' disease and to assess the response to treatment. Ten patients were prospectively studied with objective measures of strength and endurance of proximal and distal muscles while hyperthyroid (stage I), after 2 weeks of propranolol (stage II), and about 6 months later when euthyroid (stage III). Propranolol treatment for 2 weeks resulted in a subjective decrease in weakness, which was accompanied by a statistically significant improvement in grip strength (P less than 0.01), shoulder strength (P less than 0.02), and grip endurance (P less than 0.01) but not shoulder endurance. Muscle function further improved and attained control levels when the patients were chemically and clinically euthyroid. In contrast, a control group subjected to the same muscle testing protocol before and after 1 week of propranolol treatment showed no improvement in grip, shoulder strength, or shoulder endurance but had decreased grip endurance (P less than 0.01) and increased subjective weakness. These results confirm that muscle weakness commonly is associated with hyperthyroidism and can be quantitatively profound. In contrast to the effects of beta-blockade in normal controls, propranolol partially improves muscle weakness in thyrotoxic patients. We conclude that thyroid hormone and catecholamines in concert mediate the muscle dysfunction of hyperthyroidism.
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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 [117]
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 [117]
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- Authors
- Olson, B. R., Klein, I., Benner, R., Burdett, R., Trzepacz, P., & Levey, G. S.
- Affiliations
- University of Pittsburgh (US)
- Venue
- Thyroid
- Publisher
- SAGE Publications
- Published
- 1991-04
- Volume
- 1
- Issue
- 2
- Pages
- 137-141
- ISSN
- 1050-7256 (ISSN-L)
- 1557-9077
- OpenAlex
- W2034066903
- Cited by
- 81
- References
- 17
- Citations by year
- 2026: 5 · 2025: 2 · 2024: 1 · 2023: 2 · 2022: 6 · 2021: 4 · 2020: 6 · 2019: 2 · 2017: 1 · 2015: 5 · 2013: 2 · 2012: 4
- FWCI
- 0.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Thyroid (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (1r01hl041304-01, 5r29mh044964-05)
- National Heart, Lung, and Blood Institute (HL-41304)
- National Institute of Mental Health (MH 44964-04)
- National Center for Research Resources (5 MO1 RR 00056)
- 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
- Graves' disease, propranolol, beta-adrenergic blockade, muscle weakness, grip strength, muscular endurance, thyroid hormones, catecholamines, treatment response
- MeSH terms
- Adrenergic beta-Antagonists, Adult, Catecholamines, Female, Humans, Hyperthyroidism, Male, Middle Aged, Muscle Contraction, Muscular Diseases, Physical Endurance, Propranolol, Thyroid Hormones
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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