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. 2012 Dec;167(6):809-15.
doi: 10.1530/EJE-12-0501. Epub 2012 Sep 18.

Fatigue and fatigue-related symptoms in patients treated for different causes of hypothyroidism

Marloes Louwerens  1 , Bente C Appelhof, Herman Verloop, Marco Medici, Robin P Peeters, Theo J Visser, Anita Boelen, Eric Fliers, Johannes W A Smit, Olaf M Dekkers
Affiliations

Fatigue and fatigue-related symptoms in patients treated for different causes of hypothyroidism

Marloes Louwerens et al. Eur J Endocrinol. 2012 Dec.

Abstract

Objective: Research on determinants of well-being in patients on thyroid hormone replacement therapy is warranted, as persistent fatigue-related complaints are common in this population. In this study, we evaluated the impact of different states of hypothyroidism on fatigue and fatigue-related symptoms. Furthermore, the relationship between fatigue and the TSH receptor (TSHR)-Asp727Glu polymorphism, a common genetic variant of the TSHR, was analyzed.

Design: A cross-sectional study was performed in 278 patients (140 patients treated for differentiated thyroid carcinoma (DTC) and 138 with autoimmune hypothyroidism (AIH)) genotyped for the TSHR-Asp727Glu polymorphism.

Methods: The multidimensional fatigue inventory (MFI-20) was used to assess fatigue, with higher MFI-20 scores indicating more fatigue-related complaints. MFI-20 scores were related to disease status and Asp727Glu polymorphism status.

Results: AIH patients scored significantly higher than DTC patients on all five MFI-20 subscales (P<0.001), independent of clinical and thyroid hormone parameters. The frequency of the TSHR-Glu727 allele was 7.2%. Heterozygous DTC patients had more favorable MFI-20 scores than wild-type DTC patients on four of five subscales. The modest effect of the TSHR-Asp727Glu polymorphism on fatigue was found in DTC patients only.

Conclusions: AIH patients had significantly higher levels of fatigue compared with DTC patients, which could not be attributed to clinical or thyroid hormone parameters. The modest effect of the TSHR-Asp727Glu polymorphism on fatigue in DTC patients should be confirmed in other cohorts.

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