DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20190351

Clinical profiling of subclinical hypothyroidism at presentation at tertiary care center

Sanjay Mishra, Arjit Gupta

Abstract


Background: Subclinical hypothyroidism (SCH) is defined as serum thyroid-stimulating hormone (TSH) level above upper limit of normal despite normal levels of serum free thyroxine, stable over a period of one month in the absence of any non thyroidal illness. Present study is aimed at evaluating prevalence of SCH in developing countries and evaluating the clinical spectrum of these patients highlighting the importance of treatment of SCH.

Methods: Total number of 120 patients with established SCH was enrolled for the study over 3 years. The values were measured by third generation non-isotopic immunochemiluminiscence method using the standard protocol as indicated in the kit.

Results: Patients were aged 15-50 years old. The most common manifestation was generalized weakness, lethargy and tiredness (60%) followed by generalized body ache (52.5%). 46.7% % of the patients had complaints of weight gain. Triglyceride levels and serum cholesterol levels were deranged in 28.3% of all cases. Body mass index was increased in 28.3% of all patients with obesity in only 2 patients. 15 patients (11.7%) were found to be anaemic with increased MCV and MCH/MCHC, attributable to hypothyroidism.

Conclusions: These symptoms caused significant debilitated life style and poor outcome in SCH patients. Treatment of these patients can help in improving their lifestyle and perform better on daily basis.


Keywords


Hypothyroidism, TSH, Thyroxine (T4), Subclinical hypothyroidism

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References


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

Ross DS. Braverman LE. The Thyroid: A fundamental and clinical text. 8th ed. Philadelphia: Lippincott Williams and Wilkins; 2000:1001-1006.

Pearce SH, Brabant G, Duntas LH, Monzani F, Peeters RP, Razvi S, et al. 2013 ETA guideline: management of subclinical hypothyroidism. Euro Thy J. 2013;2(4):215-28.

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

Karmisholt J, Andersen S, Laurberg P. Variation in thyroid function tests in patients with stable untreated subclinical hypothyroidism. Thyroid. 2008;18(3):303-8.

Mikhail G, Alshammari S, Alenezi M, Mansour M, Khalil N. Increased atherogenic lowdensity lipoprotein cholesterol in untreated subclinical hypothyroidism. Endocr Pract. 2008;14:570.

Unnikrishnan AG, Menon UV. Thyroid disorders in India: An epidemiological perspective. Ind J Endocrinol Meta. 2011;15(Suppl2):S78-S81.

Hoogendoorn EH, Hermus AR, de Vegt F, Ross HA, Verbeek AL, Kiemency LA, et al. Thyroid function and prevalence of anti-thyroperoxidase antibodies in a population with borderline sufficient iodine intake: Influences of age and sex. Clin Chem. 2006;52:104-11.

Bemben DA, Hamm RM, Morgan L, Winn P, Davis A, Barton E. Thyroid disease in the elderly. Part 2. Predictability of subclinical hypothyroidism. J Fam Pract. 1994;38:583-8.

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

Murray MT, Lyon MR. Hunger Free Forever: The New Science of Appetite Control. Simon and Schuster; 2008 Dec 30.

Tng EL. The debate on treating subclinical hypothyroidism. Sing Med J. 2016;57(10):539-45.

Seshadri KG. Subclinical hypothyroidism in children. Ind J Endocrinol Meta. 2012;16(Suppl 2):S156-8.

Roberts CG, Ladenson PW. Hypothyroidism. Lancet. 2004;363(9411):793-803.