Health Status, Mood, and Cognition in Experimentally Induced Subclinical Thyrotoxicosis

Overview

Journal J Clin Endocrinol Metab

Publisher Oxford University Press

Specialty Endocrinology

Date 2008 Feb 21

PMID 18285414

Citations 10

Authors

M H Samuels

K G Schuff

N E Carlson

P Carello

J S Janowsky

Affiliations

Soon will be listed here.

Abstract

Objective: Our objective was to determine whether subclinical thyrotoxicosis alters health status, mood, and/or cognitive function.

Design: This was a double-blinded, randomized, cross-over study of usual dose l-T(4) (euthyroid arm) vs. higher dose l-T(4) (subclinical thyrotoxicosis arm) in hypothyroid subjects.

Patients: A total of 33 hypothyroid subjects receiving l-T(4) were included in the study.

Measurements: Subjects underwent measurements of health status, mood, and cognition: Short Form 36 (SF-36); Profile of Mood States (POMS); and tests of declarative memory (Paragraph Recall, Complex Figure), working memory (N-Back, Subject Ordered Pointing, and Digit Span Backwards), and motor learning (Pursuit Rotor). These were repeated after 12 wk on each of the study arms.

Results: Mean TSH levels decreased from 2.15 to 0.17 mU/liter on the subclinical thyrotoxicosis arm (P < 0.0001), with normal mean free T(4) and free T(3) levels. The SF-36 physical component summary and general health subscale were slightly worse during the subclinical thyrotoxicosis arm, whereas the mental health subscale was marginally improved. The POMS confusion, depression, and tension subscales were improved during the subclinical thyrotoxicosis arm. Motor learning was better during the subclinical thyrotoxicosis arm, whereas declarative and working memory measures did not change. This improvement was related to changes in the SF-36 physical component summary and POMS tension subscales and free T(3) levels.

Conclusions: We found slightly impaired physical health status but improvements in measures of mental health and mood in l-T(4) treated hypothyroid subjects when subclinical thyrotoxicosis was induced in a blinded, randomized fashion. Motor learning was also improved. These findings suggest that thyroid hormone directly affects brain areas responsible for affect and motor function.

Citing Articles

Enhanced Well-Being Associated with Thyrotoxicosis: A Neglected Effect of Thyroid Hormones?.

Perros P, Hegedus L Int J Endocrinol Metab. 2022; 20(2):e127230.

PMID: 35993034 PMC: 9375936. DOI: 10.5812/ijem-127230.

Redefinition of Successful Treatment of Patients With Hypothyroidism. Is TSH the Best Biomarker of Euthyroidism?.

Fitzgerald S, Falhammar H Front Endocrinol (Lausanne). 2022; 13:920854.

PMID: 35784560 PMC: 9243528. DOI: 10.3389/fendo.2022.920854.

What Is the Quality of Life in Patients Treated with Levothyroxine for Hypothyroidism and How Are We Measuring It? A Critical, Narrative Review.

Borson-Chazot F, Terra J, Goichot B, Caron P J Clin Med. 2021; 10(7).

PMID: 33808358 PMC: 8037475. DOI: 10.3390/jcm10071386.

Evidence-Based Use of Levothyroxine/Liothyronine Combinations in Treating Hypothyroidism: A Consensus Document.

Jonklaas J, Bianco A, Cappola A, Celi F, Fliers E, Heuer H Eur Thyroid J. 2021; 10(1):10-38.

PMID: 33777817 PMC: 7983670. DOI: 10.1159/000512970.

Evidence-Based Use of Levothyroxine/Liothyronine Combinations in Treating Hypothyroidism: A Consensus Document.

Jonklaas J, Bianco A, Cappola A, Celi F, Fliers E, Heuer H Thyroid. 2020; 31(2):156-182.

PMID: 33276704 PMC: 8035928. DOI: 10.1089/thy.2020.0720.

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