Health Status, Mood, and Cognition in Experimentally Induced Subclinical Thyrotoxicosis
Open accessAbstract
Objective: Our objective was to determine whether subclinical thyrotoxicosis alters health status, mood, and/or cognitive function. Design: This was a double-blinded, randomized, cross-over study of usual dose l-T4 (euthyroid arm) vs. higher dose l-T4 (subclinical thyrotoxicosis arm) in hypothyroid subjects. Patients: A total of 33 hypothyroid subjects receiving l-T4 were included in the study. Measurements: Subjects underwent measurements of health status, mood, and cognition: Short Form 36 (SF-36); Profile of Mood States (POMS); and tests of declarative memory (Paragraph Recall, Complex Figure), working memory (N-Back, Subject Ordered Pointing, and Digit Span Backwards), and motor learning (Pursuit Rotor). These were repeated after 12 wk on each of the study arms. Results: Mean TSH levels decreased from 2.15 to 0.17 mU/liter on the subclinical thyrotoxicosis arm (P < 0.0001), with normal mean free T4 and free T3 levels. The SF-36 physical component summary and general health subscale were slightly worse during the subclinical thyrotoxicosis arm, whereas the mental health subscale was marginally improved. The POMS confusion, depression, and tension subscales were improved during the subclinical thyrotoxicosis arm. Motor learning was better during the subclinical thyrotoxicosis arm, whereas declarative and working memory measures did not change. This improvement was related to changes in the SF-36 physical component summary and POMS tension subscales and free T3 levels. Conclusions: We found slightly impaired physical health status but improvements in measures of mental health and mood in l-T4 treated hypothyroid subjects when subclinical thyrotoxicosis was induced in a blinded, randomized fashion. Motor learning was also improved. These findings suggest that thyroid hormone directly affects brain areas responsible for affect and motor function.
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In one study of iatrogenic hyperthyroidism induced by LT4 therapy, patients had impaired scores on physical health subscales but improved scores of mental health and mood.
“in one study of iatrogenic hyperthyroidism induced by LT4 therapy, patients had impaired scores on physical health subscales, but improved scores of mental health and mood, perhaps contributing to heterogeneity in patient preferences (56).”
From Evidence-Based Use of Levothyroxine/Liothyronine Combinations in Treating Hypothyroidism: A Consensus Document (2021) · cites this paper as [56]
In one study of iatrogenic hyperthyroidism induced by LT4 therapy, patients had impaired scores on physical health subscales but improved scores of mental health and mood.
“For example, in one study of iatrogenic hyperthyroidism induced by LT4 therapy, patients had impaired scores on physical health subscales, but improved scores of mental health and mood, perhaps contributing to heterogeneity in patient preferences [56].”
From Evidence-Based Use of Levothyroxine/Liothyronine Combinations in Treating Hypothyroidism: A Consensus Document (2021) · cites this paper as [56]
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- Authors
- Samuels, M. H., Schuff, K. G., Carlson, N. E., Carello, P., & Janowsky, J. S.
- Affiliations
- Oregon Health & Science University (US)
- Corresponding author
- Samuels, M. H.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2008-05-01
- Volume
- 93
- Issue
- 5
- Pages
- 1730-1736
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- PMC
- PMC2386685
- OpenAlex
- W2095890553
- Cited by
- 39
- References
- 52
- Citations by year
- 2026: 2 · 2024: 2 · 2022: 3 · 2021: 4 · 2020: 1 · 2019: 1 · 2018: 1 · 2017: 2 · 2016: 2 · 2015: 3 · 2014: 3 · 2013: 2 · 2012: 3
- FWCI
- 2.41
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (R21DK062787)
- National Center for Research Resources (UL1 RR 024120, K01RR024120)
- 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
- subclinical thyrotoxicosis, levothyroxine, hypothyroidism, health status, mood, cognitive function, motor learning, working memory, declarative memory, free triiodothyronine, TSH suppression
- MeSH terms
- Adult, Affect, Cognition, Double-Blind Method, Female, Health Status, Humans, Male, Memory, Middle Aged, Thyroid Function Tests, Thyrotoxicosis, Cross-Over Studies
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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