Both sensorimotor and autonomic neuropathy may be common in hypothyroidism, despite treatment

[helvella]

Just saw this from diogenes' collaborator, Johannes W. Dietrich.

Both sensorimotor and autonomic neuropathy may be common in hypothyroidism, despite treatment

Bojana Bazika-Gerasch, Nina Kumowski, Elena Enax-Krumova, Miriam Kaisler, Lynn Bernadette Eitner, Christoph Maier, Johannes W. Dietrich

Scientific Reports, May 2024, Springer Science + Business Media

DOI: 10.1038/s41598-024-63158-w

What is it about?

A new study may provide a previously unknown reason for reduced quality of life in treated hypothyroidism (syndrome T).

Systematic investigations of persons with treated hypothyroidism revealed unique signs of sensorimotor dysfunction in quantitative sensory testing (QST). Being marked by thermal and mechanical hypersensitivity, the pattern differs from the constellation seen in diabetes and other conditions leading to polyneuropathy. This may explain some of the sensory symptoms of syndrome T.

Additionally, the study found reduced heart rate variability (HRV), depending on the titres of thyroid autoantibodies. This observation, indicating possible autonomic neuropathy, could explain the components of syndrome T that affect the circulatory system.

Other results of the study included that both anxiety and depression were significantly more expressed in subjects with autoimmune thyroiditis and that they were also associated with antibody titres.

The autonomic function significantly correlated with anxiety and depression, too. Additionally, the depression percentiles in the hospital anxiety and depression scale (HADS) were negatively associated with step-up deiodinase activity (SPINA-GD). In a control group with normal thyroid function, both autonomic and sensorimotor function correlated with the thyroid’s secretory capacity (SPINA-GT).

Why is it important?

About 10% of all patients with treated hypothyroidism report ongoing health issues, including fatigue, impaired memory (“brain fog”), depression, hair loss, palpitations, propensity to fainting, weight gain, both cold and heat intolerance, and fibromyalgia-like musculoskeletal pain. The reasons for this condition, which is referred to as “syndrome T” or “syndrome of residual symptoms of hypothyroidism on T4” (SORSHOT), are unknown. Potential mechanisms include psychological issues, autoimmunity of the thyroid, comorbid autoimmunity affecting other organs, inappropriate dosage of thyroid hormone and wrong modality of treatment (i.e. therapy with levothyroxine only, omitting substitution with liothyronine).

However, the evidence is still low, and important questions remain unanswered. The results of the new study may reveal some missing pieces of the jigsaw.

Perspectives

“

The study shows that patients with hypothyroidism may suffer from polyneuropathy, even if sufficiently treated with levothyroxine. This observation may pave the way to novel treatment modalities for syndrome T.

”

PD Dr. med. Johannes W Dietrich

Ruhr-Universitat Bochum

growkudos.com/publications/...

[Regenallotment]

very interesting 🤔

[Jaydee1507 Administrator]

Indeed many with POTS and multi system dysautonomia also have thyroid disease.

I'm sure it will take years for better treatment but in the mean time a better understanding from doctors would go a long way.