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Pérez Fernández MR, Martínez Lede I, Fernández-Varela MM, Fariñas-Valiña N, Calvo Ayuso N, Rodríguez-Garrido JI. [Depressive symptoms in a sample of women with subclinical hypothyroidism and their relationship to chlorates in tap water]. NUTR HOSP 2024. [PMID: 38328922 DOI: 10.20960/nh.04919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024] Open
Abstract
INTRODUCTION depressive symptoms may develop in subclinical hypothyroidism and their presence usually facilitates recognition and the establishment of replacement treatment; however, recent studies have found no association between the two. Be-sides, thyroid function can be affected by endocrine disruptors and some of them, such as chlorates, can be found in the water we drink. OBJECTIVES to know if the type of water consumed may influence the development of depressive symptoms in patients with subclinical hypothyroidism. METHODS 96 women with subclinical hypothyroidism, without thyroid treatment, par-ticipated from a health area in Spain. We studied, among other variables, the presence of depressive symptoms, type of water consumption (tap, bottled or spring) and the level of chlorates in the tap water. RESULTS 41.7 % (40) of women presented depressive symptoms and these were related to the consumption of tap water (p = 0.001), resulting in a reliable predictor (OR, 27.79; p = 0.007). Chlorate level in the tap water was 250 µg/L, a value within the maximum limit allowed by law. CONCLUSIONS chronic exposure to chlorates in water, in women with subclinical hypo-thyroidism, at levels authorized by law, could favor the inhibition of iodine transport and the appearance of depressive symptoms. It would be interesting to test this hy-pothesis as well as its possible effect on other population profiles.
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Kotb E, El Mancy IM, Mohamed IGR, Ayoub HSA, Rashed ASM, El-Nasser WS, Hamed HI, Aladl HA, Sabrh M, Eliwa A, Ghamry EM, Abdelhamed MR, Mahmoud TM. Relationship between Subclinical Hypothyroidism and Uremic Pruritis in Hemodialysis Patients. Endocr Metab Immune Disord Drug Targets 2024; 24:235-241. [PMID: 37165587 DOI: 10.2174/1871530323666230509103021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/11/2023] [Accepted: 03/15/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND AND AIM Uremic pruritus (UP) is one of the most distressing symptoms in hemodialysis (HD) patients. Subclinical hypothyroidism (SCH) is a biochemical condition with high prevalence in HD patients. The present multicentric study aimed to assess the relationship between UP and SCH in HD patients. METHODS The present cross-sectional study included 328 HD patients. All patients were submitted to careful history through clinical examination and standard laboratory assessment. Pruritis was evaluated using the pruritis visual analog scale (VAS). Patients were diagnosed with SCH if they had TSH levels above the upper limit of the normal reference range in association with normal free thyroxine (FT4) levels. RESULTS Among the studied patients, there were 196 patients (59.8 %) with UP. Comparison between patients with UP and patients without revealed that patients in the former group had significantly longer HD duration (median (IQR): 47.5 (27.0-72.5) versus 36.0 (23.0-50.5) months, p < 0.001) and lower Kt/v (median (IQR): 1.4 (1.09-1.7) versus 1.54 (1.12-1.91), p = 0.009). Moreover, they had significantly higher ferritin (median (IQR): 653.0 (526.0-800.0) versus 628.0 (470.8- 716.0) ng/mL), hsCRP (median (IQR): 12.0 (8.0-14.0) versus 8.0 (6.0-9.0) mg/dL, p < 0.001) and TSH levels (median (IQR): 4.34 (1.98-5.2) versus 3.34 (1.9-4.85) μIU/ml) with a significantly higher frequency of SCH (45.9 % versus 28.8 %, p = 0.002). Logistic regression analysis identified hemodialysis duration (OR (95%) CI): 1.02 (1.009-1.028), p < 0.001), ferritin levels (OR (95% CI): 1.002 (1.001-1.003), p < 0.001), and SCH (OR (95% CI): 0.54 (0.32-0.89), p = 0.016) as significant predictors of UP. CONCLUSION The present study suggested a possible link between SCH and the development of UP in HD patients.
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Affiliation(s)
- Essam Kotb
- Department of Internal Medicine, October 6 University, Giza, Egypt
| | | | | | | | | | | | | | | | - Mostafa Sabrh
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed Eliwa
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Esam M Ghamry
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | | | - Tamer M Mahmoud
- Internal Medicine Department, Beni-Suef University, Beni-Suef, Egypt
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Duñabeitia I, González-Devesa D, Varela-Martínez S, Diz-Gómez JC, Ayán-Pérez C. Effect of physical exercise in people with hypothyroidism: systematic review and meta-analysis. Scand J Clin Lab Invest 2023; 83:523-532. [PMID: 37999992 DOI: 10.1080/00365513.2023.2286651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 11/19/2023] [Indexed: 11/26/2023]
Abstract
This study aimed to systematically revise the available evidence on the effects of physical exercise training programmes on people with hypothyroidism. Comparative studies were searched in six electronic databases until April 2023. The Physiotherapy Evidence Database and the Methodological Index for Non-Randomized Studies were used to determine the methodological quality of the randomized controlled trials and comparative studies respectively. A total of 10 studies were found showing a low to moderate methodological quality. Most of them were performed in women with subclinical hypothyroidism. Exercise seemed to be safe, with aerobic and resistance training leading to improvements in outcomes related to physical and mental health. The performed meta-analysis with data from 120 participants indicated that exercise showed a non-significant trend towards reducing thyroid-stimulating hormone levels (Hedges'g -0.96; 95% CI -2.71; 0.79, p = 0.160; I2 = 92%). When the analysis was performed by comparing the experimental, and control groups with data from 180 participants the results remained non-significant (SMD -1.09; CI 95% -2.88; 0.70, p = 0.23; I2 = 95%). Similar findings were obtained when pooling data for FT3 and FT4 levels. Exercise does not have a significant impact on thyroid function, although its practice can lead to secondary outcomes related to physical and mental health.
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Affiliation(s)
- Iratxe Duñabeitia
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
- RIDEAIDI, Research Network on People with Disability: Exercise, Physical Activity and Inclusive Sport, Consejo Superior de Deportes (CSD), Spain
| | - Daniel González-Devesa
- Facultad de Ciencias de la Actividad Física y del Deporte, Universidad de León, León, Spain
| | - Silvia Varela-Martínez
- RIDEAIDI, Research Network on People with Disability: Exercise, Physical Activity and Inclusive Sport, Consejo Superior de Deportes (CSD), Spain
- Well-Move Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
- Departamento de Didácticas Especiais, Universidade de Vigo, Vigo, Spain
| | - Jose Carlos Diz-Gómez
- RIDEAIDI, Research Network on People with Disability: Exercise, Physical Activity and Inclusive Sport, Consejo Superior de Deportes (CSD), Spain
- Well-Move Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
- Departamento de Didácticas Especiais, Universidade de Vigo, Vigo, Spain
| | - Carlos Ayán-Pérez
- RIDEAIDI, Research Network on People with Disability: Exercise, Physical Activity and Inclusive Sport, Consejo Superior de Deportes (CSD), Spain
- Well-Move Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
- Departamento de Didácticas Especiais, Universidade de Vigo, Vigo, Spain
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Martin M, Subramaniyan R, Naik D, Ramamoorthy L, Lalthanthuami HT. Health-related quality of life and its association with the symptom score and the thyroid function status of patients with primary hypothyroidism on replacement therapy. J Family Community Med 2023; 30:280-286. [PMID: 38044967 PMCID: PMC10688588 DOI: 10.4103/jfcm.jfcm_103_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 07/14/2023] [Accepted: 08/09/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND A number of patients with primary hypothyroidism have reduced health-related quality of life (HR-QoL), even with optimum thyroid hormone replacement therapy. This study aimed to assess the HR-QoL of patients with hypothyroidism under replacement therapy and identify its relationship with the symptom score and thyroid function status. MATERIALS AND METHODS Using a cross-sectional study design, 175 hypothyroid patients under replacement therapy who visited the Endocrinology Outpatient Department of a tertiary care center were selected by convenient sampling technique. Data was collected using a structured data collection tool comprising, HR-QoL Short Form-36 questionnaire, and Zulewski's clinical score. Inferential statistical analyses were performed using Mann-Whitney U, Kruskal-Wallis, and Karl-Pearson Correlation tests. RESULTS The overall mean quality of life score was 44.22 ± 12.14, with a substantial decline in role functioning because of physical health. A significant negative correlation (P < 0.05) was found between HR-QoL and hypothyroidism symptom score. A significant association was observed between participants' HR-QoL and their dosage of thyroxine supplement (P < 0.05,) but no association was found with thyroid function status. CONCLUSION There was a substantial reduction in the quality of life of the patients despite being on thyroid replacement therapy and achieving euthyroid status. This underlines the importance of symptom reduction and hormone optimization to enhance the quality of life.
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Affiliation(s)
- Merina Martin
- Medical Surgical Nursing, College of Nursing, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Rani Subramaniyan
- Medical Surgical Nursing, College of Nursing, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Dhukhabandu Naik
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Lakshmi Ramamoorthy
- Medical Surgical Nursing, College of Nursing, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Hmar T. Lalthanthuami
- Medical Surgical Nursing, College of Nursing, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Hassan MAE, El-Gharieb HA, Nasr M, Abdelhay WM, Yousef TSM, El-Zamek HMF, Zidan AM, Nady M, Abdel-Kareem MA, Hasan A. Potential Association between Subclinical Hypothyroidism and Childhood Migraine. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58101346. [PMID: 36295508 PMCID: PMC9610765 DOI: 10.3390/medicina58101346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Migraine is caused by genetic susceptibility that is triggered by environmental as well as biological factors, and it is also linked to many somatic comorbidities, including clinical and subclinical hypothyroidism. We aimed to estimate the potential association between subclinical hypothyroidism (ScH) and migraine in children at our tertiary hospital. Materials and Methods: Using a case−control strategy, 200 children and adolescents were assigned to two equal groups: a case group (patients with migraine) of 100 patients and a control group of 100 patients without migraine. Clinical and biochemical parameters (TSH, FT4) were compared between the groups using statistical analysis. Results: Thyroid function comparison between the groups showed higher TSH but normal FT4 among children with migraine headache compared to the control group, which means more frequent ScH cases among the migraine group relative to the control (17% vs. 2%, p < 0.001). Obesity and overweight were more frequent among patients with migraine than the control group (8 and 5% vs. 2 and 1%, respectively). The (overweight/obese) patients with migraine had about 77% ScH and 15.4% overt hypothyroidism compared to 8% ScH and no overt hypothyroidism among normal body weight migraine patients (p < 0.001). No significant difference in the prevalence of nodular goiter between patients with migraine and controls was found. Conclusions: Based on our results, subclinical hypothyroidism is significantly linked to childhood migraine. Obesity and being overweight are more frequent among patients with migraine. Therefore, it may be logical to test the thyroid function in migraineur children, especially those with high BMI. Further studies are recommended to discover the mechanism of this association in children.
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Affiliation(s)
| | | | - Mohamed Nasr
- Histology Department, Faculty of Medicine, Al-Azhar University, Cairo 11884, Egypt
| | - Wagih M. Abdelhay
- Histology Department, Faculty of Medicine, Al-Azhar University, Cairo 11884, Egypt
| | | | | | - Ahmed M. Zidan
- Radio-diagnosis Department, Faculty of Medicine, Al-Azhar University, Cairo 11884, Egypt
| | - Mohamed Nady
- Otorhinolaryngology Department, Faculty of Medicine, Al-Azhar University, Cairo 11884, Egypt
| | - Mona A. Abdel-Kareem
- Anatomy Department, Faculty of Medicine, Kafr Elsheikh University, Kafr Elsheikh 33516, Egypt
| | - Abdulkarim Hasan
- Departments of Pathology, Faculty of Medicine, Al-Azhar University, Cairo 11884, Egypt
- Correspondence: or ; Tel.: +20-002-022-4012-932
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