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Background and objective <p>The relationship between quality of life (QoL) and thyroid stimulating hormone (TSH) levels in patients receiving levothyroxine (LT4) therapy is unclear. Our aim was to determine the efficacy of replacement therapy and the relationship between TSH concentration and QoL in patients diagnosed with primary hypothyroidism and receiving LT4 replacement therapy.</p> Methods <p>This is a national retrospective cross-sectional study. Demographic information, a questionnaire for diagnosis and management of thyroid diseases and Thyroid related Patient Reported Outcome (ThyPRO ) and EQ-5D questionnaires to assess quality of life were used to collect data. The study included retrospective 3 year follow up data.</p> Results <p>Our study included 1750 patients (90.3% female, 9.7% male) from 26 centers with a mean age of 47.8 ± 12.6 years (18–88) and a body mass index of 28.84 ± 5.89&#xa0;kg/m2. Patients had been receiving levothyroxine replacement for 10.23 ± 7.03 (3–55) years. The mean number of visits during the three-year follow-up period was 6.34 ± 2.78 [<CitationRef AdditionalCitationIDS="CR2 CR3 CR4 CR5 CR6 CR7 CR8 CR9 CR10 CR11 CR12 CR13 CR14 CR15 CR16 CR17 CR18 CR19 CR20 CR21" CitationID="CR1">1</CitationRef>–<CitationRef CitationID="CR22">22</CitationRef>]. A total of 188 patients (10.7%) had never reached the specific TSH target. The target TSH value was reached &lt; 3 times (<i>n</i> = 715; 40.8%), 3–5 times (<i>n</i> = 775; 44.2%), and ≥ 6 times (<i>n</i> = 260; 14.8%). According to the ThyPRO questionnaire, patients who achieved their treatment target fewer than 3 times had higher (worse thyroid related quality of life) scores in several domains, including goiter symptoms, hyper-/hypothyroid symptoms, fatigue, cognitive complaints, anxiety, depression, and impairments in social, sexual, and daily functioning. In contrast, these patients had lower EQ-5D scores, indicating poorer overall health-related quality of life.</p> Conclusion <p>In hypothyroidism replacement therapy, it is crucial to establish an individualized TSH target, and the patient’s cognitive functions and quality of life are positively impacted by the attainment of euthyroidism.</p>

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Investigating the relationship between thyroid replacement therapy goals status and quality of life in patients with primary hypothyroidism

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  • 发表日期：

    2026年5月2日

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  • Ayşe Kubat Üzüm,
  • Zeynel Abidin Sayiner,
  • Kader Uğur,
  • Sadettin Öztürk,
  • Güzide Gonca Örük,
  • Ayten Eraydın,
  • Havva Sezer,
  • Abbas Ali Tam,
  • Fatma Nur Korkmaz,
  • Çiğdem Tura Bahadır,
  • Ziynet Alphan Üç,
  • Filiz Ekşi Haydardedeoğlu,
  • Mehtap Evran,
  • Barış Karagün,
  • Emre Saygılı,
  • Dilek Tüzün,
  • Züleyha Karaca,
  • Hülya Hacışahinoğulları,
  • Gülhan Akbaba,
  • Meriç Coşkun,
  • Tayfun Garip,
  • Müge Özsan Yılmaz,
  • Eren Gürkan,
  • Gökçen Ünal Kocabaş,
  • Nurdan Gül,
  • Mustafa Koçak,
  • Ahmet Numan Demir,
  • Güven Barış Cansu,
  • Mustafa Kulaksızoğlu,
  • Mustafa Ünübol,
  • Murat Çalapkulu,
  • Mehmet Muhittin Yalçın,
  • Füsun Baloş Törüner,
  • Mustafa Sait Gönen,
  • Mehmet Erdoğan,
  • Dilek Yazıcı,
  • Bekir Çakır,
  • Murat Faik Erdoğan,
  • Ersin Akarsu

摘要

Background and objective

The relationship between quality of life (QoL) and thyroid stimulating hormone (TSH) levels in patients receiving levothyroxine (LT4) therapy is unclear. Our aim was to determine the efficacy of replacement therapy and the relationship between TSH concentration and QoL in patients diagnosed with primary hypothyroidism and receiving LT4 replacement therapy.

Methods

This is a national retrospective cross-sectional study. Demographic information, a questionnaire for diagnosis and management of thyroid diseases and Thyroid related Patient Reported Outcome (ThyPRO ) and EQ-5D questionnaires to assess quality of life were used to collect data. The study included retrospective 3 year follow up data.

Results

Our study included 1750 patients (90.3% female, 9.7% male) from 26 centers with a mean age of 47.8 ± 12.6 years (18–88) and a body mass index of 28.84 ± 5.89 kg/m2. Patients had been receiving levothyroxine replacement for 10.23 ± 7.03 (3–55) years. The mean number of visits during the three-year follow-up period was 6.34 ± 2.78 [1–22]. A total of 188 patients (10.7%) had never reached the specific TSH target. The target TSH value was reached < 3 times (n = 715; 40.8%), 3–5 times (n = 775; 44.2%), and ≥ 6 times (n = 260; 14.8%). According to the ThyPRO questionnaire, patients who achieved their treatment target fewer than 3 times had higher (worse thyroid related quality of life) scores in several domains, including goiter symptoms, hyper-/hypothyroid symptoms, fatigue, cognitive complaints, anxiety, depression, and impairments in social, sexual, and daily functioning. In contrast, these patients had lower EQ-5D scores, indicating poorer overall health-related quality of life.

Conclusion

In hypothyroidism replacement therapy, it is crucial to establish an individualized TSH target, and the patient’s cognitive functions and quality of life are positively impacted by the attainment of euthyroidism.