Sarah J Peterson1, Anne R Cappola2, M Regina Castro3, Colin M Dayan4, Alan P Farwell5, James V Hennessey6, Peter A Kopp7, Douglas S Ross8, Mary H Samuels9, Anna M Sawka10, Peter N Taylor4, Jacqueline Jonklaas11, Antonio C Bianco1. 1. 1 Division of Endocrinology and Metabolism, Rush University Medical Center , Chicago, Illinois. 2. 2 Division of Endocrinology, Diabetes, and Metabolism, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania. 3. 3 Division of Endocrinology, Mayo Clinic , Rochester, Minnesota. 4. 4 Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine , Cardiff, United Kingdom . 5. 5 Division of Endocrinology, Diabetes and Nutrition, Boston Medical Center/Boston University , Boston, Massachusetts. 6. 6 Division of Endocrinology, Beth Israel Deaconess Medical Center , Boston, Massachusetts. 7. 7 Feinberg School of Medicine, Northwestern University , Chicago, Illinois. 8. 8 Thyroid Associates, Massachusetts General Hospital , Boston, Massachusetts. 9. 9 Oregon Clinical and Translational Research Institute, Oregon Health and Science University , Portland, Oregon. 10. 10 University Health Network and University of Toronto , Toronto, Canada . 11. 11 Division of Endocrinology, Georgetown University , Washington, DC.
Abstract
BACKGROUND: Approximately 15% more patients taking levothyroxine (LT4) report impaired quality of life compared to controls. This could be explained by additional diagnoses independently affecting quality of life and complicating assignment of causation. This study sought to investigate the underpinnings of reduced quality of life in hypothyroid patients and to provide data for discussion at a symposium addressing hypothyroidism. METHODS: An online survey for hypothyroid patients was posted on the American Thyroid Association Web site and forwarded to multiple groups. Respondents were asked to rank satisfaction with their treatment for hypothyroidism and their treating physician. They also ranked their perception regarding physician knowledge about hypothyroidism treatments, need for new treatments, and life impact of hypothyroidism on a scale of 1-10. Respondents reported the therapy they were taking, categorized as LT4, LT4 and liothyronine (LT4 + LT3), or desiccated thyroid extract (DTE). They also reported sex, age, cause of hypothyroidism, duration of treatment, additional diagnoses, and prevalence of symptoms. RESULTS: A total of 12,146 individuals completed the survey. The overall degree of satisfaction was 5 (interquartile range [IQR] = 3-8). Among respondents without self-reported depression, stressors, or medical conditions (n = 3670), individuals taking DTE reported a higher median treatment satisfaction of 7 (IQR = 5-9) compared to other treatments. At the same time, the LT4 treatment group exhibited the lowest satisfaction of 5 (IQR = 3-7), and for the LT4 + LT3 treatment group, satisfaction was 6 (IQR = 3-8). Respondents taking DTE were also less likely to report problems with weight management, fatigue/energy levels, mood, and memory compared to those taking LT4 or LT4 + LT3. CONCLUSIONS: A subset of patients with hypothyroidism are not satisfied with their current therapy or their physicians. Higher satisfaction with both treatment and physicians is reported by those patients on DTE. While the study design does not provide a mechanistic explanation for this observation, future studies should investigate whether preference for DTE is related to triiodothyronine levels or other unidentified causes.
BACKGROUND: Approximately 15% more patients taking levothyroxine (LT4) report impaired quality of life compared to controls. This could be explained by additional diagnoses independently affecting quality of life and complicating assignment of causation. This study sought to investigate the underpinnings of reduced quality of life in hypothyroidpatients and to provide data for discussion at a symposium addressing hypothyroidism. METHODS: An online survey for hypothyroidpatients was posted on the American Thyroid Association Web site and forwarded to multiple groups. Respondents were asked to rank satisfaction with their treatment for hypothyroidism and their treating physician. They also ranked their perception regarding physician knowledge about hypothyroidism treatments, need for new treatments, and life impact of hypothyroidism on a scale of 1-10. Respondents reported the therapy they were taking, categorized as LT4, LT4 and liothyronine (LT4 + LT3), or desiccated thyroid extract (DTE). They also reported sex, age, cause of hypothyroidism, duration of treatment, additional diagnoses, and prevalence of symptoms. RESULTS: A total of 12,146 individuals completed the survey. The overall degree of satisfaction was 5 (interquartile range [IQR] = 3-8). Among respondents without self-reported depression, stressors, or medical conditions (n = 3670), individuals taking DTE reported a higher median treatment satisfaction of 7 (IQR = 5-9) compared to other treatments. At the same time, the LT4 treatment group exhibited the lowest satisfaction of 5 (IQR = 3-7), and for the LT4 + LT3 treatment group, satisfaction was 6 (IQR = 3-8). Respondents taking DTE were also less likely to report problems with weight management, fatigue/energy levels, mood, and memory compared to those taking LT4 or LT4 + LT3. CONCLUSIONS: A subset of patients with hypothyroidism are not satisfied with their current therapy or their physicians. Higher satisfaction with both treatment and physicians is reported by those patients on DTE. While the study design does not provide a mechanistic explanation for this observation, future studies should investigate whether preference for DTE is related to triiodothyronine levels or other unidentified causes.
Authors: E T Massolt; M van der Windt; T I M Korevaar; B L R Kam; J W Burger; G J H Franssen; I Lehmphul; J Köhrle; W E Visser; R P Peeters Journal: Clin Endocrinol (Oxf) Date: 2016-06-13 Impact factor: 3.478
Authors: Thanh D Hoang; Cara H Olsen; Vinh Q Mai; Patrick W Clyde; Mohamed K M Shakir Journal: J Clin Endocrinol Metab Date: 2013-03-28 Impact factor: 5.958
Authors: John P Walsh; Lauren Shiels; Ee Mun Lim; Chotoo I Bhagat; Lynley C Ward; Bronwyn G A Stuckey; Satvinder S Dhaliwal; Gerard T Chew; Minoti C Bhagat; Andrea J Cussons Journal: J Clin Endocrinol Metab Date: 2003-10 Impact factor: 5.958
Authors: Luba Freja Michaelsson; Bjarke Borregaard Medici; Jeppe Lerche la Cour; Christian Selmer; Michael Røder; Hans Perrild; Nils Knudsen; Jens Faber; Birte Nygaard Journal: Eur Thyroid J Date: 2015-08-14
Authors: W Siegmund; K Spieker; A I Weike; T Giessmann; C Modess; T Dabers; G Kirsch; E Sänger; G Engel; A O Hamm; M Nauck; W Meng Journal: Clin Endocrinol (Oxf) Date: 2004-06 Impact factor: 3.478
Authors: Benjamin Van Tassell; George F Wohlford; Joyce D Linderman; Sheila Smith; Sahzene Yavuz; Frank Pucino; Francesco S Celi Journal: Thyroid Date: 2019-09-12 Impact factor: 6.568
Authors: Omar Saeed; Lori J Bernstein; Rouhi Fazelzad; Mary Samuels; Lynn A Burmeister; Lehana Thabane; Shereen Ezzat; David P Goldstein; Jennifer Jones; Anna M Sawka Journal: J Cancer Surviv Date: 2019-04-04 Impact factor: 4.442
Authors: Nazanene H Esfandiari; David Reyes-Gastelum; Sarah T Hawley; Megan R Haymart; Maria Papaleontiou Journal: Thyroid Date: 2019-10-10 Impact factor: 6.568
Authors: Sungro Jo; Tatiana L Fonseca; Barbara M L C Bocco; Gustavo W Fernandes; Elizabeth A McAninch; Anaysa P Bolin; Rodrigo R Da Conceição; Joao Pedro Werneck-de-Castro; Daniele L Ignacio; Péter Egri; Dorottya Németh; Csaba Fekete; Maria Martha Bernardi; Victoria D Leitch; Naila S Mannan; Katharine F Curry; Natalie C Butterfield; J H Duncan Bassett; Graham R Williams; Balázs Gereben; Miriam O Ribeiro; Antonio C Bianco Journal: J Clin Invest Date: 2018-12-03 Impact factor: 14.808
Authors: Rodrigo R Da Conceição; Gustavo W Fernandes; Tatiana L Fonseca; Barbara M L C Bocco; Antonio C Bianco Journal: Thyroid Date: 2018-11 Impact factor: 6.568