Matthew D Ettleson1, Ava Raine2, Alice Batistuzzo3, Samuel P Batista3, Elizabeth McAninch4, Maria Cristina T V Teixeira3, Jacqueline Jonklaas5, Neda Laiteerapong6, Miriam O Ribeiro3, Antonio C Bianco7. 1. University of Chicago, Section of Endocrinology, Diabetes, and Metabolism, Chicago, Illinois. Electronic address: Matthew.Ettleson@uchospitals.edu. 2. Carleton College, Northfield, Minnesota. 3. Developmental Disorders Program, Center for Biological Sciences and Health, Mackenzie Presbyterian University, Sao Paulo SP, Brazil. 4. Stanford University Medical Center, Division of Endocrinolgoy, Gerontology, and Metabolism, Stanford Hospital, Stanford, California. 5. Georgetown University Medical Center, Division of Endocrinology, Washington, DC. 6. University of Chicago, Section of General Internal Medicine, Chicago, Illinois. 7. University of Chicago, Section of Endocrinology, Diabetes, and Metabolism, Chicago, Illinois.
Abstract
OBJECTIVE: Patient-centered studies have shown that several patients on thyroid hormone replacement therapy for hypothyroidism exhibit persistent symptoms, including "brain fog." Here, we aimed to determine which of these specific symptoms are associated with brain fog, identify patient-reported factors that modify these symptoms, and identify patient concerns related to brain fog not included in thyroid-specific questionnaires. METHODS: A survey on brain fog symptoms adapted from thyroid-specific patient-reported outcome was distributed online. Textual data analysis was performed to identify common areas of concern from open-ended survey responses. RESULTS: A total of 5170 participants reporting brain fog while being treated for hypothyroidism were included in the analysis. Of these, 2409 (46.6%) participants reported symptom onset prior to the diagnosis of hypothyroidism, and 4096 (79.2%) participants experienced brain fog symptoms frequently. Of the symptoms listed, participants associated fatigue and forgetfulness most frequently with brain fog. More rest was the most common factor provided for improving symptoms. The textual data analysis identified areas of concern that are not often included in thyroid-specific quality of life questionnaires, including a focus on the diagnosis of hypothyroidism, the types and doses of medications, and the patient-doctor relationship. CONCLUSION: Brain fog in patients treated for hypothyroidism was associated most frequently with fatigue and cognitive symptoms. Several additional areas of patient concern were found to be associated with brain fog, which are not typically addressed in thyroid-specific questionnaires.
OBJECTIVE: Patient-centered studies have shown that several patients on thyroid hormone replacement therapy for hypothyroidism exhibit persistent symptoms, including "brain fog." Here, we aimed to determine which of these specific symptoms are associated with brain fog, identify patient-reported factors that modify these symptoms, and identify patient concerns related to brain fog not included in thyroid-specific questionnaires. METHODS: A survey on brain fog symptoms adapted from thyroid-specific patient-reported outcome was distributed online. Textual data analysis was performed to identify common areas of concern from open-ended survey responses. RESULTS: A total of 5170 participants reporting brain fog while being treated for hypothyroidism were included in the analysis. Of these, 2409 (46.6%) participants reported symptom onset prior to the diagnosis of hypothyroidism, and 4096 (79.2%) participants experienced brain fog symptoms frequently. Of the symptoms listed, participants associated fatigue and forgetfulness most frequently with brain fog. More rest was the most common factor provided for improving symptoms. The textual data analysis identified areas of concern that are not often included in thyroid-specific quality of life questionnaires, including a focus on the diagnosis of hypothyroidism, the types and doses of medications, and the patient-doctor relationship. CONCLUSION: Brain fog in patients treated for hypothyroidism was associated most frequently with fatigue and cognitive symptoms. Several additional areas of patient concern were found to be associated with brain fog, which are not typically addressed in thyroid-specific questionnaires.
Authors: Sarah J Peterson; Anne R Cappola; M Regina Castro; Colin M Dayan; Alan P Farwell; James V Hennessey; Peter A Kopp; Douglas S Ross; Mary H Samuels; Anna M Sawka; Peter N Taylor; Jacqueline Jonklaas; Antonio C Bianco Journal: Thyroid Date: 2018-04-05 Impact factor: 6.568
Authors: Barbara M L C Bocco; João Pedro Werneck-de-Castro; Kelen C Oliveira; Gustavo W Fernandes; Tatiana L Fonseca; Bruna P P Nascimento; Elizabeth A McAninch; Esther Ricci; Zsuzsanna Kvárta-Papp; Csaba Fekete; Maria Martha Bernardi; Balázs Gereben; Antonio C Bianco; Miriam O Ribeiro Journal: Endocrinology Date: 2016-08-08 Impact factor: 4.736