International Journal of Medical and Dental Sciences

Open Access Open Access  Restricted Access Subscription Access

Clinical Profile of Subclinical Hypothyroidism:A Retrospective Study


Affiliations
1 Department of General Medicine, Nizam’s Institute of Medical Sciences, Punjagutta, Hyderabad, India
 

Background: Subclinical hypothyroidism occurs due to an under functioning thyroid gland and presents with varied symptoms and signs. Thyroid disorders are common in Indian population and the prevalence of subclinical hypothyroidism is high.

Objective: This study intended to assess the clinical profile of patients presenting with subclinical hypothyroidism.

Materials and Methods: This was a retrospective study that analyzed the medical records of adult patients diagnosed with subclinical hypothyroidism for a period of three years.

Results: 71 patients within the age range of 18 years to 77 years were diagnosed with subclinical hypothyroidism. Among these 53 (75%) patients had various clinical symptoms. Body pains were the most common symptom (38 %) followed by weight gain(27%) and tiredness (20%). A significant number of patients were obese (25%). Enlarged thyroid(14%) and dyslipidemia (25%) were also recorded. 63 (75%) patients were initiated on low dose levothyroxine.

Conclusion: Patients with subclinical hypothyroidism present with varied non-specific clinical symptoms. Treatment with low dose levothyroxine resulted in lowering of serum TSH to normal range and relief of symptoms.


Keywords

Hypothyroidsm, Thyroid Stimulating Hormone (TSH), Thyroxine (T4), Triiodothronine (T3), Levothroxine.
User
Notifications
Font Size


  • Douglas S. Ross subclinical hypothyroidism. In: Braverman LE, Utiger RD, editors. Werner and Ingbar's The Thyroid: A fundamental and clinical text. 8th ed. Philadelphia: Lippincott Williams and Wilkins; 2000. p.1001-6.

  • Cooper DS, Biondi B. Subclinical thyroid disease. Lancet 2012;379(1079):1142-54.

  • Vanderpump MPJ, Tunbridge WMG, French JM, Appleton D, Bates D, Clark F, et al. The incidence of thyroid disorders in the community: a twenty year followup of the Whickham survey. Clin Endocrinol 1995;43:55-68.

  • Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Arch Intern Med 2000 Feb 28;160(4):526-34.

  • Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA, Braverman LE. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J ClinEndocrinolMetab 2002 Feb; 87(2):489-99.

  • Desai MP. Disorders of thyroid gland in India. Indian J Pediatr 1997 Jan-Feb;64(1):11-20.

  • Rohil V, Mishra AK, Shrewastawa MK, Mehta KD, Lamsal M, Baral N, et al. Subclinical hypothyroidism in eastern Nepal: a hospital based study. Kathmandu Univ Med J (KUMJ) 2010 Apr-Jun;8(30):231-7.

  • Papaleontiou M, Cappola AR. Thyroid-Stimulating Hormone in the Evaluation of Subclinical Hypothyroidism. JAMA. 2016;316(15):1592-3.

  • Vaishali D, Anishbehl I, Harish J, Jayshree PD, Prema KV, Prevalence, Clinical and Biochemical Profile of Subclinical Hypothyroidism in Normal Population in Mumbai. Indian Journal of Endocrinology and Metabolism 2013:17(3):454-9.

  • Bemben DA, Hamm RM, Morgan L, Winn P, Davis A, Barfen E, et al. Thyroid disease in the elderly. Part 2. Predictability of subclinical hypothyroidism. J Fam Pract 1994;38:583-88.

  • Villar HC, Saconato H, Valente O, Atallah AN. Thyroid hormone replacement for subclinical hypothyroidism. Cochrane Database Syst Rev 2007;3:CD003419.

  • Rodondi N, den Elzen WPJ, Bauer DC, Cappola AR, Razvi S, Walsh JP, et al. Thyroid Studies Collaboration FT. Subclinical Hypothyroidism and the Risk of Coronary Heart Disease and Mortality. JAMA 2010;304(12):1365-74.

  • Ravi Shekhar, NVS Chowdary, MC Das, Desai Vidya, Siva Prabodh. Prevalence of subclinical hypothyroidism in coastal Andhra Pradesh. Biomedical Research 2011;22(4):471-4.

  • Pucci E, Chiovato L, Pinchera A. Thyroid and lipid metabolism. Int J Obes Relat Metab Disord 2000 Jun;24Suppl 2:S109-12.

  • Misiunas A, Niepomniszcze H, Ravera B, Faraj G, Faure E. Peripheral neuropathy in Subclinical Hypothyroidism. Thyroid 1995;5:283-8.

  • Penza P, Lombardi R, Camozzi F, Clanno C, Lauria G. Painful neuropathy in subclinical hypothyroidism: clinical and neuropathological recovery after hormone replacement therapy Neurol Sci 2009;30:149-51.

  • Reuters VS, Teixeira Pde F, Vigario PS, Almeida CP, Buescu A, Ferreira MM, et al. Functional capacity and muscular abnormalities in subclinical hypothyroidism. Am J Med Sci 2009 Oct;338(4):259-63.

  • Chakrabarti S. Thyroid Functions and Bipolar Affective Disorder. Journal of Thyroid Research 2011;306-67.

  • Pasqualetti G, Pagano G, Rengo G, Ferrara N, Monzani F. Subclinical Hypothyroidism and Cognitive Impairment: Systematic Review and Meta-Analysis. The Journal of Clinical Endocrinology & Metabolism 2015;100(11):4240-8.

  • Gencer B, Rodondi N. Evidence and controversies regarding the screening for subclinical hypothyroidism in patients with cardiovascular disease. Journal of Thoracic Disease 2016;8(6):E446-50.

  • Rizos C, Elisaf M, Liberopoulos E. Effects of Thyroid Dysfunction on Lipid Profile. The Open Cardiovascular Medicine Journal 2011;5:76-84.

  • US Preventive Services Task Force. Screening for thyroid disease: recommendation statement. Am Fam Physician 2004 May 15;69(10):2415-8.

  • Senthilkumaran S, Sathyaprakash V, Sundararajan A. A Study on Prevalence and Distribution of Subclinical Hypothyroidism in Rural Women. Sch J App Med Sci 2015;3(1D):287-90.

  • Sampath S, Singh P, Somani BL, Arrora MM, Batra HS, Haritha AC, Ambade. Study of clinicobiochemical spectrum of hypothyroidism. Med J Arm For Ind 2007;jul,63(3);233-6.

  • Usha MV, Sundaram KR, Unnikrishnan AG, Jayakumar RV, Nair V, Kumar H. High prevalence of undetected thyroid disorders in an iodine sufficient adult south Indian population. J Indian Med Assoc 2009;107:72-7.

  • Goulis DG, Tsimpiris N, Delaroudis S, Maltas B, Tzoiti M, Dagilas A, et al. Stapedial reflex: a biological index found to be abnormal in clinical and subclinical hypothyroidism. Thyroid 1998;8(7):583-7.

  • Simon HS, Pearce George B, Leonidas H, Duntas, Fabio M, Robin P. 2013 ETA Guidline: Management of subclinical hypothyroidism. E ur Thy 2013;2(4):215-28.

  • Razvi S, Ingoe L, Keeka G, Oates C, Mcmilllan C. The beneficial effect of L -thyroxine on cardiovascular risk factors, endothelial function, and quality of life in subclinical hypothyroidism: randomized, crossover trial. J Clin Endocrinol Metab 2007;92(5):1715-23.


Abstract Views: 258

PDF Views: 107




  • Clinical Profile of Subclinical Hypothyroidism:A Retrospective Study

Abstract Views: 258  |  PDF Views: 107

Authors

Mallikarjuna Shetty
Department of General Medicine, Nizam’s Institute of Medical Sciences, Punjagutta, Hyderabad, India
Krishna Prasad Adiraju
Department of General Medicine, Nizam’s Institute of Medical Sciences, Punjagutta, Hyderabad, India
Nageswar Rao Modugu
Department of General Medicine, Nizam’s Institute of Medical Sciences, Punjagutta, Hyderabad, India

Abstract


Background: Subclinical hypothyroidism occurs due to an under functioning thyroid gland and presents with varied symptoms and signs. Thyroid disorders are common in Indian population and the prevalence of subclinical hypothyroidism is high.

Objective: This study intended to assess the clinical profile of patients presenting with subclinical hypothyroidism.

Materials and Methods: This was a retrospective study that analyzed the medical records of adult patients diagnosed with subclinical hypothyroidism for a period of three years.

Results: 71 patients within the age range of 18 years to 77 years were diagnosed with subclinical hypothyroidism. Among these 53 (75%) patients had various clinical symptoms. Body pains were the most common symptom (38 %) followed by weight gain(27%) and tiredness (20%). A significant number of patients were obese (25%). Enlarged thyroid(14%) and dyslipidemia (25%) were also recorded. 63 (75%) patients were initiated on low dose levothyroxine.

Conclusion: Patients with subclinical hypothyroidism present with varied non-specific clinical symptoms. Treatment with low dose levothyroxine resulted in lowering of serum TSH to normal range and relief of symptoms.


Keywords


Hypothyroidsm, Thyroid Stimulating Hormone (TSH), Thyroxine (T4), Triiodothronine (T3), Levothroxine.

References





DOI: https://doi.org/10.18311/ijmds%2F2017%2F149899