Hashimoto's Thyroiditis Affects Symptom Load and Quality of Life Unrelated to Hypothyroidism: A Prospective Case–Control Study in Women Undergoing Thyroidectomy for Benign Goiter
Abstract
Background Hashimoto's thyroiditis (HT) is a common disease, and is the most prevalent cause of hypothyroidism. Symptoms and diseases associated with HT are considered to be caused by hypothyroidism. We hypothesized that higher antithyroperoxidase (anti-TPO) antibody levels would be associated with an increased symptom load and a decreased quality of life in a female euthyroid patient collective. Methods In a prospective cohort study 426 consecutive euthyroid female patients undergoing thyroid surgery for benign thyroid disease were included. Main outcome measures were preoperative anti-TPO levels, a symptom questionnaire and the SF-36 questionnaire, and lymphocytic infiltration of the thyroid tissue as evaluated by histology. Results Histology revealed HT in 28/426 (6.6%) subjects. To maximize the sum of the predictive values, a cut-off point for anti-TPO of 121.0 IU/mL was calculated (sensitivity 93.3% [95% confidence interval: 77.9%-99.0%]; specificity 94.7% [95% confidence interval: 92.0%-96.7%]) to predict the presence of histological signs of HT. The mean number of reported symptoms was significantly higher in patients with anti-TPO levels >121.0 IU/mL than in the other group (6.7 ± 2.5 vs. 4.1 ± 2.8; p Conclusions Women with HT suffer from a high symptom load. Hypothyroidism is only a contributing factor to the development of associated conditions.
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In an Austrian study of 426 euthyroid women undergoing thyroid surgery, patients with TPO-Ab >121 kU/l had higher rates of chronic fatigue, dry hair, chronic irritability, chronic nervousness and lower quality of life than those with TPO-Ab <121 kU/l, with no difference in serum TSH levels or thyroid hormone replacement use.
“Patients with TPO-Ab 1 121 kU/l had higher rates for several symptoms including chronic fatigue, dry hair, chronic irritability, chronic nervousness and lower quality of life (SF-36 questionnaire) than those patients with TPO-Ab !121 kU/l; there was no difference in serum TSH levels or the use of thyroid hormone replacement therapy (29%) between both groups.”
From 2012 ETA Guidelines: The Use of L-T4 + L-T3 in the Treatment of Hypothyroidism (2012) · cites this paper as [25]
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- Authors
- Ott, J., Promberger, R., Kober, F., Neuhold, N., Tea, M., Huber, J. C., & Hermann, M.
- Affiliations
- Medical University of Vienna (AT)
- Department of Surgery, Kaiserin Elisabeth Spital, Vienna, Austria.
- Department of Pathology and Microbiology, Kaiserin Elisabeth Spital, Vienna, Austria.
- Corresponding author
- Ott, Johannes
- Venue
- Thyroid
- Publisher
- SAGE Publications
- Published
- 2011-02
- Volume
- 21
- Issue
- 2
- Pages
- 161-167
- ISSN
- 1050-7256 (ISSN-L)
- 1557-9077
- OpenAlex
- W2075285534
- Cited by
- 190
- References
- 1
- Citations by year
- 2026: 10 · 2025: 15 · 2024: 16 · 2023: 12 · 2022: 10 · 2021: 13 · 2020: 12 · 2019: 15 · 2018: 12 · 2017: 10 · 2016: 2 · 2015: 10 · 2014: 20 · 2013: 11 · 2012: 18
- FWCI
- 7.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Thyroid (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
- Hashimoto's thyroiditis, thyroid peroxidase antibodies, symptom burden, quality of life, euthyroid women, benign goiter, thyroidectomy, chronic fatigue, thyroid autoimmunity, thyroid-stimulating hormone
- MeSH terms
- Adult, Aged, Antibodies, Anti-Idiotypic, Anxiety, Fatigue, Female, Goiter, Health Status, Health Surveys, Humans, Hypothyroidism, Iodide Peroxidase, Middle Aged, Prospective Studies, Quality of Life, Thyroidectomy, Case-Control Studies, Outcome Assessment, Health Care, Mood Disorders, Hashimoto Disease
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