title: Disease-Specific as Well as Generic Quality of Life Is Widely Impacted in Autoimmune Hypothyroidism and Improves during the First Six Months of Levothyroxine Therapy.
abstract: BACKGROUND
  Hypothyroidism is often diagnosed, and subsequently treated, due to health-related quality of life (HRQL) issues. However, HRQL following treatment has never previously been assessed in longitudinal descriptive studies using validated instruments.
  
  
  OBJECTIVE
  To investigate disease-specific (ThyPRO) and generic (SF-36) HRQL, following levothyroxine therapy in patients with hypothyroidism due to autoimmune thyroiditis.
  
  
  METHODS
  This prospective cohort study was set at endocrine outpatient clinics at two Danish university hospitals. Seventy-eight consecutive patients were enrolled and completed HRQL questionnaires before, six weeks, and six months after initiation of levothyroxine therapy. Normative ThyPRO (n = 739) and SF-36 (n = 6,638) data were available for comparison and changes in HRQL following treatment were estimated and quantified.
  
  
  RESULTS
  Prior to treatment, all ThyPRO scales were significantly impacted (p<0.0001), compared to the general population sample. The same was observed for seven of eight SF-36 scales, the exception being Bodily Pain. Tiredness (ThyPRO) and Vitality (SF-36) were the most markedly impacted scales. After six weeks of treatment, nine of thirteen ThyPRO scales had significantly improved. ThyPRO improvements were consistent at six months, where five of eight SF-36 scales had also significantly improved, but deficits persisted for a subset of both ThyPRO and SF-36 scales.
  
  
  CONCLUSIONS
  In this population of hypothyroid patients, HRQL was widely affected before treatment, with tiredness as the cardinal impairment according to both ThyPRO and SF-36. Many aspects of HRQL improved during the first six months of LT4 therapy, but full recovery was not obtained. Our results may help clinicians inform patients about expected clinical treatment effects.
authors.affiliation: Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark.|Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
authors.forename: Kristian Hillert
authors.initials: KH
authors.lastname: Winther
authors.affiliation: Department of Medical Endocrinology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Per
authors.initials: P
authors.lastname: Cramon
authors.affiliation: Department of Medical Endocrinology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.|Department of Internal Medicine, Gentofte Hospital, Copenhagen, Denmark.
authors.forename: Torquil
authors.initials: T
authors.lastname: Watt
authors.affiliation: Department of Public Health, University of Copenhagen, Copenhagen, Denmark.|Optum Insight Inc, Eden Prairie, MN, United States of America.
authors.forename: Jakob Bue
authors.initials: JB
authors.lastname: Bjorner
authors.affiliation: National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
authors.forename: Ola
authors.initials: O
authors.lastname: Ekholm
authors.affiliation: Department of Medical Endocrinology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Ulla
authors.initials: U
authors.lastname: Feldt-Rasmussen
authors.affiliation: Department of Public Health, University of Copenhagen, Copenhagen, Denmark.|Department of Palliative Medicine, Bispebjerg University Hospital, Copenhagen, Denmark.
authors.forename: Mogens
authors.initials: M
authors.lastname: Groenvold
authors.affiliation: Department of Medical Endocrinology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Åse Krogh
authors.initials: ÅK
authors.lastname: Rasmussen
authors.affiliation: Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark.|Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
authors.forename: Laszlo
authors.initials: L
authors.lastname: Hegedüs
authors.affiliation: Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark.|Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
authors.forename: Steen Joop
authors.initials: SJ
authors.lastname: Bonnema
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D050031:Hashimoto Disease / Q000188:drug therapy* / Q000503:physiopathology*; D006728:Hormones / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013967:Thyroiditis, Autoimmune / Q000188:drug therapy* / Q000503:physiopathology*; D013974:Thyroxine / Q000627:therapeutic use*; D013997:Time Factors; D055815:Young Adult
chemical_list: D006728:Hormones; D013974:Thyroxine