title: Differences in physicians' and patients' perception of acute hypothyroid symptoms induced by thyroid hormone withdrawal in thyroid cancer patients: a multicenter survey in Korea.
abstract: BACKGROUND
  Acute short-term hypothyroidism induced by thyroid hormone withdrawal (THW) for follow-up surveillance or therapeutic radioiodine causes patients with differentiated thyroid cancer to suffer from a myriad of deleterious symptoms.
  
  
  OBJECTIVE
  To know how patient recognition of hypothyroid symptoms compares to physician perception of patient symptoms.
  
  
  METHODS
  The survey was performed in 10 referral hospitals throughout Korea from December 2010 to May 2011 and targeted patients with total thyroidectomy and remnant ablation. The survey consisted of questions regarding the effect of THW on patient symptoms, the duration of symptoms, impact on social life, and patient complaints. The physicians treating thyroid cancer patients also responded to the survey and provided their perceptions of patient symptoms and treatment decisions.
  
  
  RESULTS
  About 70% of the patients responded that they experienced a negative physical or psychological impact on their life and work due to hypothyroid symptoms. However, 76% of doctors thought hypothyroidism could negatively impact a patient's daily life but would be endurable. Two thirds of physicians do not routinely recommend recombinant human TSH (rhTSH) to their patients. Multivariate analysis showed patients with female sex, stronger educational background, emotionally negative experiences of hypothyroidism, and younger age were more willing to pay for therapy that could prevent hypothyroidism symptoms.
  
  
  CONCLUSIONS
  There was a substantial gap in the perception of hypothyroid symptoms during THW between physicians and patients. Physicians who are aware of the seriousness of hypothyroidism in their patients were more likely to recommend the use of rhTSH for their patients.
authors.affiliation: Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea.
authors.forename: Dong Jun
authors.initials: DJ
authors.lastname: Lim
authors.affiliation: Department of Internal Medicine, Asan Medical Center, Seoul National University Hospital, Busan, Korea.
authors.forename: Won Bae
authors.initials: WB
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
authors.forename: Bo Hyun
authors.initials: BH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Asan Medical Center, Seoul National University Hospital, Busan, Korea.
authors.forename: Tae Yong
authors.initials: TY
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Young Suk
authors.initials: YS
authors.lastname: Jo
authors.affiliation: Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Ho-Cheol
authors.initials: HC
authors.lastname: Kang
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Busan, Korea.
authors.forename: Young Joo
authors.initials: YJ
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Korea Cancer Center Hospital, Busan, Korea.
authors.forename: Ka Hee
authors.initials: KH
authors.lastname: Yi
authors.affiliation: Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Minho
authors.initials: M
authors.lastname: Shong
authors.affiliation: Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
authors.forename: In Joo
authors.initials: IJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Busan, Korea.
authors.forename: Do Joon
authors.initials: DJ
authors.lastname: Park
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Busan, Korea.
authors.forename: Sun Wook
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Busan, Korea.
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Chung
authors.affiliation: Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, Korea.
authors.forename: Jaetae
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea.
authors.forename: Sung-Soo
authors.initials: SS
authors.lastname: Koong
authors.affiliation: Department of Internal Medicine, Asan Medical Center, Seoul National University Hospital, Busan, Korea.
authors.forename: Young Kee
authors.initials: YK
authors.lastname: Shong
keywords: Hypothyroidism; Patients; Physicians; Symptoms; Thyroid cancer