title: The influence of a biopsychosocial-based treatment approach to primary overt hypothyroidism: a protocol for a pilot study.
abstract: BACKGROUND
  Hypothyroidism is a prevalent endocrine condition. Individuals with this disease are commonly managed through supplementation with synthetic thyroid hormone, with the aim of alleviating symptoms and restoring normal thyroid stimulating hormone levels. Generally this management strategy is effective and well tolerated. However, there is research to suggest that a significant proportion of hypothyroid sufferers are being inadequately managed. Furthermore, hypothyroid patients are more likely to have a decreased sense of well-being and more commonly experience constitutional and neuropsychiatric complaints, even with pharmacological intervention.The current management of hypothyroidism follows a biomedical model. Little consideration has been given to a biopsychosocial approach to this condition. Within the chiropractic profession there is growing support for the use of a biopsychosocial-based intervention called Neuro-Emotional Technique (NET) for this population.
  
  
  METHODS
  A placebo-controlled, single-blinded, randomised clinical pilot-trial has been designed to assess the influence of Neuro-Emotional Technique on a population with primary overt hypothyroidism. A sample of 102 adults (≥18 years) who meet the inclusion criteria will be randomised to either a treatment group or a placebo group. Each group will receive ten treatments (NET or placebo) over a six week period, and will be monitored for six months. The primary outcome will involve the measurement of depression using the Depression, Anxiety and Stress Scale (DASS). The secondary outcome measures to be used are; serum thyroid stimulating hormone, serum free-thyroxine, serum free-triiodothyronine, serum thyroid peroxidase auto-antibodies, serum thyroglobulin auto-antibodies as well as the measurement of functional health and well-being using the Short-Form-36 Version 2. The emotional states of anxiety and stress will be measured using the DASS. Self-measurement of basal heart rate and basal temperature will also be included among the secondary outcome measures. The primary and secondary measures will be obtained at commencement, six weeks and six months. Measures of basal heart rate and basal temperature will be obtained daily for the six month trial period, with recording to commence one week prior to the intervention.
  
  
  CONCLUSIONS
  The study will provide information on the influence of NET when added to existing management regimens in individuals with primary overt hypothyroidism.
  
  
  BACKGROUND
  ANZCTR Number: 12607000040460.
authors.affiliation: Department of Chiropractic, Macquarie University, NSW, 2109 Australia. benjamin.brown@students.mq.edu.au
authors.forename: Benjamin T
authors.initials: BT
authors.lastname: Brown
authors.forename: Rod
authors.initials: R
authors.lastname: Bonello
authors.forename: Henry
authors.initials: H
authors.lastname: Pollard
authors.forename: Petra
authors.initials: P
authors.lastname: Graham
mesh_terms: D000328:Adult; D001007:Anxiety / Q000209:etiology; D001323:Autoantibodies / Q000097:blood; D015415:Biomarkers / Q000097:blood; D003863:Depression / Q000209:etiology; D004644:Emotions; D006801:Humans; D007037:Hypothyroidism / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D026441:Mind-Body Therapies; D009517:New South Wales; D010865:Pilot Projects; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012107:Research Design; D016037:Single-Blind Method; D013315:Stress, Psychological / Q000209:etiology; D013963:Thyroid Hormones / Q000097:blood; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D013963:Thyroid Hormones