This paper shows the now-accepted idea that T4 therapy does not restore QOL.
Journal of Clinical Medicine
J. Clin. Med. 2020, 9, 3864; doi:10.3390/jcm9123864
Health‐Related Quality of Life in LevothyroxineTreated Hypothyroid Women and Women without Hypothyroidism: A Case–Control Study
Benjamín Romero‐Gómez1 , Paula Guerrero‐Alonso2 , Juan Manuel Carmona‐Torres3,4,5 , Diana P. Pozuelo‐Carrascosa3,4 , José Alberto Laredo‐Aguilera3,4,5, * and Ana Isabel Cobo‐Cuenca3,4,5
4
Received: 7 November 2020; Accepted: 26 November 2020; Published: 27 November 2020
Abstract: The use of levothyroxine is not always related to the elimination of the symptoms of hypothyroidism. The aim of this study is to compare the health‐related quality of life (HRQOL) of a group of hypothyroid women under levothyroxine treatment with that of a group of nonhypothyroid women. Methodology: A case–control study was performed. We used convenience sampling. The case group consisted of 152 levothyroxine‐treated hypothyroid women; the control group consisted of 238 women without hypothyroidism disorders. All of the participants were euthyroid according to the clinical practice guidelines. We used as instruments the Short Form‐12 questionnaire (SF‐12v1) and a sociodemographic questionnaire. Results: Hypothyroid women scored significantly lower in HRQOL in SF‐12v1 mental and physical components than the control group (mental component summary: 41.23 ± 12.12 vs 46.45 ± 10.22, p < 0.001; physical component summary: 49.64 ± 10.16 vs 54.75 ± 5.76, p < 0.001). body mass index (BMI) and age showed an influence on the physical component (p < 0.001 in both variables). Adjusted for age and BMI, hypothyroidism was still related to worse scores (p < 0.001). Conclusion: Despite being euthyroid, women with hypothyroidism showed a poorer quality of life than women without hypothyroidism. Health professionals need to assess the HRQOL of women with hypothyroidism. Further research on HRQOL and hypothyroidism is needed.
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Are we seeing the persistent drip of evidence (re non/poor response to levo) slowly penetrating the granite type resistance to change by medics and decision makers? Hopefully!
How widely are these papers read....or given serious thought?
How likely is this to change the "neurotic woman" (or men) approach!
But if the drip continues....
We can dream!!
The number of posts that suggest T3 would be of benefit appears to be increasing as patients struggle to cope with much reduced QOL.
It seems tantamount to medical negligence!
Had I relied on medics to prescribe T3 I would, in all probability, no longer be here ranting on the subject!
Thank you, to you and your team, for all that you do towards improving thyroid diagnoses and treatments for patients.
One would hope that there are spies watching this space and gathering (some sort of) intelligence and reporting back 😜 It's only a matter of time before something changes, surely.
I am worried the reduced HRQoL will be viewed as other comorbidities causing it rather than as we know, lack of proper thyroid diagnosis, treatment and care.
When was it that NDT stopped being the standard treatment for hypothyroidism and was completely replaced with Levothyroxine(in the UK)? I've forgotten. 1970s?
Conclusion: Despite being euthyroid, women with hypothyroidism showed a poorer quality of life than women without hypothyroidism. Health professionals need to assess the HRQOL of women with hypothyroidism. Further research on HRQOL and hypothyroidism is needed.
Patients have been telling doctors about this for years. But our symptoms are always assumed to be just in our heads, and we end up being offered anti-depressants.
I suspect there is a danger that future research on QOL issues in hypothyroidism could be taken over by researchers devoted to BPS (BioPsychoSocial) theories. But BPS is a misnomer. The Bio part always gets dropped, and to a large extent so does the Social. We get left with the Psycho part and an offer of anti-depressants and offers of CBT and exercise therapy.
One thing I just noticed is that men were not included in this study, only women. I wonder what effect there would have been if they had included men, and had analysed the results for each gender separately.
diogenes I do hope you and your group continue to plug away at thyroid-related research for all our sakes. Happy New Year, by the way.
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