We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
A Comparison of Short-Term Changes in Health-Related Quality of Life in Thyroid Carcinoma Patients Undergoing Diagnostic Evaluation with Recombinant Human Thyrotropin Compared with Thyroid Hormone Withdrawal.
- Authors
Schroeder, Pamela R.; Haugen, Bryan R.; Pacini, Furio; Reiners, Christoph; Schlumberger, Martin; Sherman, Steven I.; Cooper, David S.; Schuff, Kathryn G.; Braverman, Lewis E.; Skarulis, Monica C.; Davies, Terry F.; Mazzaferri, Ernest L.; Daniels, Gilbert H.; Ross, Douglas S.; Luster, Markus; Samuels, Mary H.; Weintraub, Bruce D.; Ridgway, E. Chester; Ladenson, Paul W.
- Abstract
Context: Thyroid carcinoma requires lifelong monitoring with serum thyroglobulin, radioactive iodine whole body scanning, and other imaging modalities. Levothyroxine (L-T4) withdrawal for thyroglobulin measurement and whole body scanning increases these tests’ sensitivities but causes hypothyroidism. Recombinant human TSH (rhTSH) enables testing without L-T4 withdrawal. Objective: Our objective was to examine the impact of short-term hypothyroidism on the health-related quality of life (HRQOL) of patients after rhTSH vs. L-T4 withdrawal. Design, Setting, and Patients: In this multicenter study, the SF-36 Health Survey was administered to 228 patients at three time points: on L-T4, after rhTSH, and after L-T4 withdrawal. Interventions: Interventions included administration of rhTSH on L-T4 and withdrawal from thyroid hormone. Main Outcome Measures: Mean SF-36 scores were compared during the two interventions and with the U.S. general population and patients with heart failure, depression, and migraine headache. Results: Patients had SF-36 scores at or above the norm for the general U.S. population in six of eight domains at baseline on L-T4 and in seven of eight domains after rhTSH. Patients’ scores declined significantly in all eight domains after L-T4 withdrawal when compared with the other two periods (P < 0.0001). Patients’ HRQOL scores while on L-T4 and after rhTSH were at or above those for patients with heart failure, depression, and migraine in all eight domains. After L-T4 withdrawal, patients’ HRQOL scores were significantly below congestive heart failure, depression, and migraine headache norms in six, three, and six of the eight domains, respectively. Conclusions: Short-term hypothyroidism after L-T4 withdrawal is associated with a significant decline in quality of life that is abrogated by rhTSH use.
- Publication
Journal of Clinical Endocrinology & Metabolism, 2006, Vol 91, Issue 3, p878
- ISSN
0021-972X
- Publication type
Article
- DOI
10.1210/jc.2005-2064