Quality of Life in Patients With Hypothyroidism

The quality of life (QoL) of thyroid diseases has been less studied than other chronic diseases. There is however evidence suggesting long lasting physical and psychological symptomatology related to thyroid diseases. Objective: To analyze the QoL in patients with hypothyroidism. Methods: We evaluated 274 patients with a mean age of 56.2 ± 14.2 years, 89.1 % female and divided them by diagnosis: autoimmune thyroiditis (AIT, n = 145), multinodular goiter (MG, n = 31), total thyroidectomy (TT) for thyroid cancer (n = 46), total thyroidectomy for MG (n = 36), TT for Graves disease (GD, n = 9) and radioactive iodine therapy (RAI) for GD (n = 7), and assessed thyroid function tests, thyroid antibodies, lipid profile, high-sensitivity C-reactive protein, vitamin B12, folic acid and applied the Thyroid Dependent Quality of Life questionnaire (ThyDQoL). Statistical analysis was performed with the One-way ANOVA test and Pearson’s correlation test. P values ≤ 0.05 were considered as statistically significant. Results: In this sample, the subgroups who reported worse QoL were the TT for thyroid cancer (-2.47 points) followed by the RAI for GD (-2.14 points) and the AIT (-2.11 points), although these differences were not statistically significant. Regarding the internal domains of the ThyDQoL, we found a significant difference between the subgroup TT for thyroid cancer and MG in bodily discomfort (-4.03 ± 3.61 vs -1.47 ± 1.66; p = 0.04) and household tasks (-2.95 ± 2.92 vs -0.90 vs 1.61; p = 0.02). Within the subgroups, we observed significant correlations involving QoL and vitamin B12 in the AIT subgroup (r = 0.16; p = 0.05), between QoL and lipoprotein(a) (r = -0.50; p = 0.03) in the MG subgroup, between QoL and free T3 (r = -0.31; p = 0.03) in the TT for thyroid cancer subgroup and between QoL and free T3 (r = -0.76; p = 0.04) in the RAI for GD subgroup. Conclusions: In this study we found that patients submitted to TT for thyroid cancer had the worse QoL among patients with hypothyroidism. This may be related to the use of thyroid hormone suppressive therapy. We also observed that certain domains of QoL are more affected by some causes of hypothyroidism. Further studies are needed to analyze more deeply the symptomatology that contributes to worsening of QoL in these patients.