title: The effect of substitution therapy on symptoms in patients with hypothyroidism following treatment for laryngeal and hypopharyngeal carcinomas.
abstract: Hypothyroidism is a well-known complication following treatment of laryngeal or hypopharyngeal carcinomas, and may cause various psychological and physical problems that negatively affect quality of life. The aim of this study was to evaluate the effect of substitution therapy on symptoms in patients with hypothyroidism. A study-specific questionnaire on physical and psychological problems (before and after substitution therapy) was sent to 70 patients who had been treated between 1977 and 2008 with clinical or subclinical hypothyroidism. Ninety-four percent returned the questionnaire. Symptoms on energy levels were reported most often (67% always tired and 70% lack of energy). Moodiness and emotional and physical symptoms were reported more often in substituted (sub)clinical hypothyroidism. Substitution therapy resulted in an improvement of energy (P = 0.013), sense of general interest and enjoyment (P = 0.022) and a reduction of puffy face (P = 0.041). Most symptoms in patients with thyroid dysfunction do not improve after substitution therapy. Nevertheless, due to its impact on health-related quality of life and the low burden of substitution therapy, screening for hypothyroidism and subsequent substitution therapy remains important.
authors.affiliation: Departments of Otolaryngology / Head and Neck Surgery.
authors.forename: A M
authors.initials: AM
authors.lastname: Lo Galbo
authors.forename: I M
authors.initials: IM
authors.lastname: Verdonck-De Leeuw
authors.forename: P
authors.initials: P
authors.lastname: Lips
authors.forename: D J
authors.initials: DJ
authors.lastname: Kuik
authors.forename: C R
authors.initials: CR
authors.lastname: Leemans
authors.forename: R
authors.initials: R
authors.lastname: De Bree
mesh_terms: D020249:Hormone Replacement Therapy; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000628:therapy*; D007037:Hypothyroidism / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D007822:Laryngeal Neoplasms / Q000628:therapy*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
keywords: Head and neck cancer; Health-related quality of life; Hypopharyngeal neoplasms; Hypothyroidism; Laryngeal neoplasms; Substitution therapy
references.citation: Arch Otolaryngol Head Neck Surg. 2006 Oct;132(10):1041-6
references.pmid: 17043248
references.citation: Arch Otolaryngol Head Neck Surg. 2007 Jun;133(6):625-6
references.pmid: 17576920
references.citation: Curr Opin Otolaryngol Head Neck Surg. 2008 Apr;16(2):154-7
references.pmid: 18327035
references.citation: Acta Otolaryngol. 2007 Mar;127(3):312-7
references.pmid: 17364370
references.citation: Qual Life Res. 1994 Oct;3(5):323-7
references.pmid: 7841966
references.citation: J Gen Intern Med. 1996 Dec;11(12):744-9
references.pmid: 9016421
references.citation: Eur Arch Otorhinolaryngol. 2002 Apr;259(4):193-6
references.pmid: 12064507
references.citation: Eur J Endocrinol. 2003 Aug;149(2):91-7
references.pmid: 12887284
references.citation: N Engl J Med. 1999 Feb 11;340(6):424-9
references.pmid: 9971866
references.citation: J Clin Endocrinol Metab. 2007 May;92(5):1715-23
references.pmid: 17299073
references.citation: Arch Med Res. 2006 Jan;37(1):133-9
references.pmid: 16314199
references.citation: Cancer. 2001 Dec 1;92(11):2892-7
references.pmid: 11753963
references.citation: Am J Otolaryngol. 2007 Jan-Feb;28(1):46-9
references.pmid: 17162132
references.citation: Eur J Endocrinol. 2006 Apr;154(4):501-10
references.pmid: 16556711
references.citation: J Clin Endocrinol Metab. 2006 Jul;91(7):2624-30
references.pmid: 16670161
references.citation: Int J Radiat Oncol Biol Phys. 1997 Sep 1;39(2):303-8
references.pmid: 9308932
references.citation: Cochrane Database Syst Rev. 2007 Jul 18;(3):CD003419
references.pmid: 17636722
references.citation: Arch Intern Med. 2005 Nov 28;165(21):2460-6
references.pmid: 16314541
references.citation: Value Health. 2008 Mar-Apr;11(2):285-94
references.pmid: 18380641