title: Does low serum TSH within the normal range have negative impact on physical exercise capacity and quality of life of healthy elderly people?
abstract: OBJECTIVE
  Investigate the differences in cardiopulmonary (CP) capacity and Quality of Life (QOL) between healthy elderly (≥ 65 years) with different TSH levels (< 1.0 and ≥ 1.0 μIU/mL) both within the normal range. Also, evaluate the effects of TSH elevation on CP test and QOL, by administering methimazole to subjects with initial lower-normal TSH, in order to elevate it to superior-normal limit.
  
  
  METHODS
  Initially, a cross-sectional study was performed to compare CP capacity at peak exercise and QOL (using WHOQOL-OLD questionnaire) between healthy seniors (age ≥ 65 years) with TSH < 1.0 μIU/mL vs. TSH ≥1.0 μIU/mL. In the second phase, participants with TSH < 1.0 μIU/mL were included in a non-controlled-prospective-interventional study to investigate the effect of TSH elevation, using methimazole, on QOL and CP capacity at peak exercise.
  
  
  RESULTS
  From 89 elderly evaluated, 75 had TSH ≥ 1 μIU/mL and 14 TSH < 1 μIU/mL. The two groups had similar basal clinical characteristics. No difference in WHOQOL-OLD scores was observed between groups and they did not differ in terms of CP function at peak exercise. QOL and CP variables were not correlated with TSH levels. Twelve of 14 participants with TSH < 1.0 μIU/mL entered in the prospective study. After one year, no significant differences in clinical caracteristics, QOL, and CP variables were detected in paired analysis before and after methimazole intervention.
  
  
  CONCLUSIONS
  We found no differences in CP capacity and QOL between health elderly with different TSH levels within normal range and no impact after one year of methimazole treatment. More prospective-controlled-randomized studies are necessary to confirm or not the possible harm effect in normal low TSH.
authors.affiliation: Endocrine Clinic, University Hospital Clementino Fraga Filho (HUCFF), Rio de Janeiro, RJ, Brazil.|Estácio de Sá University, Rio de Janeiro, RJ, Brazil.|Amil Clinical Research, Rio de Janeiro, RJ, Brazil.
authors.forename: Dhiãnah Santini de Oliveira
authors.initials: DS
authors.lastname: Chachamovitz
authors.affiliation: Ergospirometry and Kinanthropometry Laboratory, Physical Education and Sports School, Federal University of Rio de Janeiro(UFRJ)Rio de Janeiro, RJ, Brazil.|Postgraduate Program of Rehabilitation Sciences, Augusto Motta University Center (Unisuam), Rio de Janeiro, RJ, Brazil.
authors.forename: Patrícia Dos Santos
authors.initials: Pdos S
authors.lastname: Vigário
authors.affiliation: Ergospirometry and Kinanthropometry Laboratory, Physical Education and Sports School, Federal University of Rio de Janeiro(UFRJ)Rio de Janeiro, RJ, Brazil.
authors.forename: Rafael Cavalcante
authors.initials: RC
authors.lastname: Carvalho
authors.affiliation: Ergospirometry and Kinanthropometry Laboratory, Physical Education and Sports School, Federal University of Rio de Janeiro(UFRJ)Rio de Janeiro, RJ, Brazil.
authors.forename: Diego Henrique da Silva
authors.initials: DH
authors.lastname: Silvestre
authors.affiliation: Estácio de Sá University, Rio de Janeiro, RJ, Brazil.
authors.forename: Ana Eduarda Vieira
authors.initials: AE
authors.lastname: Moerbeck
authors.affiliation: Estácio de Sá University, Rio de Janeiro, RJ, Brazil.
authors.forename: Mariana Guimarães
authors.initials: MG
authors.lastname: Soffientini
authors.affiliation: Estácio de Sá University, Rio de Janeiro, RJ, Brazil.
authors.forename: Érika Luciana Gomes
authors.initials: ÉL
authors.lastname: Luna
authors.affiliation: Estácio de Sá University, Rio de Janeiro, RJ, Brazil.
authors.forename: Clara Werner
authors.initials: CW
authors.lastname: Rosemberg
authors.affiliation: Ergospirometry and Kinanthropometry Laboratory, Physical Education and Sports School, Federal University of Rio de Janeiro(UFRJ)Rio de Janeiro, RJ, Brazil.|Postgraduate Program of Rehabilitation Sciences, Augusto Motta University Center (Unisuam), Rio de Janeiro, RJ, Brazil.
authors.forename: Míriam Raquel Meira
authors.initials: MR
authors.lastname: Mainenti
authors.affiliation: Endocrine Clinic, University Hospital Clementino Fraga Filho (HUCFF), Rio de Janeiro, RJ, Brazil.
authors.forename: Mário
authors.initials: M
authors.lastname: Vaisman
authors.affiliation: Endocrine Clinic, University Hospital Clementino Fraga Filho (HUCFF), Rio de Janeiro, RJ, Brazil.
authors.forename: Patricia de Fátima Dos Santos
authors.initials: Pde F
authors.lastname: Teixeira
mesh_terms: D000367:Age Factors; D000368:Aged; D000375:Aging / Q000097:blood; D013956:Antithyroid Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D017079:Exercise Tolerance / Q000187:drug effects / Q000502:physiology*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006980:Hyperthyroidism / Q000097:blood / Q000503:physiopathology; D008297:Male; D008713:Methimazole / Q000627:therapeutic use*; D010101:Oxygen Consumption / Q000187:drug effects / Q000502:physiology; D011446:Prospective Studies; D011788:Quality of Life; D012016:Reference Values; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013972:Thyrotropin / Q000097:blood* / Q000187:drug effects; D013974:Thyroxine / Q000097:blood
chemical_list: D013956:Antithyroid Agents; D008713:Methimazole; D013972:Thyrotropin; D013974:Thyroxine