REDUCTION OF SUBJECTIVE STRESS PERCEPTION IN FEMALE PATIENTS WITH AUTOIMMUNE HYPOTHYROIDISM AFTER RESTORING EUTHYROID STATUS WITH LEVOTHYROXINE TREATMENT

Authors

  • Lisandra DAMIAN “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Cristina-Mihaela GHICIUC “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Maria-Christina UNGUREANU Sapienza University of Rome, Italy
  • Francesca-Romana PATACCHIOLI Department of Physiology and Pharmacology “V. Erspamer”
  • Cătălina-Elena LUPUȘORU “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Keywords:

AUTOIMMUNE THY-ROID DISEASE, STRESS PERCEPTION, PSYCHOMETRIC

Abstract

REDUCTION OF SUBJECTIVE STRESS PERCEPTION IN FEMALE PATIENTS WITH AUTOIMMUNE HYPOTHYROIDISM AFTER RESTORING EUTHYTOID STATUS WITH LEVOTHYROXINE TREATMENT (Abstract): Autoimmune Thyroid Diseases (AITDs), comprising Graves’ Disease and Hashimoto’s Thyroiditis have a multifactorial origin and stress, as an environmental trigger, has been incriminated as the most frequent risk factor for the development of mood disorders. Also, hypothyroidism in Hashimoto’s Thyroiditis is asso-ciated with different neuro-psychiatric conditions such as concentration, memory and attention deficits, depressive mood and anxiety disorder, particularly in the female sex. Aim: to evaluate the subjective perception of stress in women with newly diagnosed autoimmune hypothyroid-ism and the influence on stress perception of restoring euthyroidism with levothyroxine (LT4) treatment. Materials and methods: we conducted a prospective study over a one-year period (October 2014 - September 2015) that included 17 female patients newly diagnosed with auto-immune hypothyroidism, with no history of psychiatric disorders or treatments and no other major ailments. Perceived stress was measured using four standardized questionnaires before and after instituting LT4 therapy. Results: All patients included in our study, with a mean age of 43.8 ± 10.8, reported a stress level in the medium range. After LT4 replacement treatment was initiated and euthyroidism was restored, subjective stress levels measured with all four questionnaires were lower compared to baseline. Furthermore, when we divided patients into subgroups, based on their reproductive status, psychometric scores of patients in the reproduc-tively active subgroup before and after LT4 treatment, were significantly lower after restaura-tion of euthyroidism, but no significant reductions were observed in the menopausal subgroup. Conclusions: further research is needed, using more objective stress measurement methods, for a more reliable determination of the impact of LT4 treatment and restauration of the euthyroid state in patients with autoimmune thyroid dysfunction.

References

1. Wiersinga WM. Thyroid autoimmunity. Endocr Dev 2014; 26: 139-157.
2. Brent GA. Environmental exposures and autoimmune thyroid disease. Thyroid 2010; 20(7): 755-761.
3. Brix TH, Kyvik KO, Christensen K, Hegedüs L. Evidence for a major role of heredity in Graves' disease: a population-based study of two Danish twin cohorts. J Clin Endocrinol Metab 2001; 86(2): 930-934.
4. Iddah MA, Macharia BN. Autoimmune thyroid disorders. ISRN Endocrinol 2013; 2013:509764.
5. Merrill SJ, Mu Y. Thyroid autoimmunity as a window to autoimmunity: An explanation for sex dif-ferences in the prevalence of thyroid autoimmunity. J Theor Biol 2015; 375: 95-100.
6. Cooper GS, Stroehla BC. The epidemiology of autoimmune diseases. Autoimmun Rev 2003; 2(3): 119-125.
7. Wémeau JL, Proust-Lemoine E, Ryndak A, Vanhove L. Thyroid autoimmunity and polyglandular endocrine syndromes. Hormones (Athens) 2013; 12(1): 39-45.
8. Damian L, Ungureanu MC, Ghiciuc CM et al. From autoimmune thyroid disease and CREST syn-drome to incidental discovery of incipient gastric carcinoma: a case report. Arch Clin Cases 2015; 2(2): 76-80.
9. Effraimidis G, Tijssen JGP, Brosschot JF, Wiersinga WM. Involvement of stress in the pathogenesis of autoimmune thyroid disease: a prospective study. Psychoneuroendocrinology 2012; 37(8): 1191-1198.
10. Damian L, Ghiciuc CM, Dima-Cozma LC et al. No definitive evidence for a connection between autoimmune thyroid diseases and stress in women. Neuro Endocrinol Lett 2016; 37(3): 155-162.
11. McEwen BS (2007). Physiology and neurobiology of stress and adaptation: Central role of the brain. Physiol Rev 87: 873-904.
12. Mocanu V, Bontea A, Anton-Păduraru DT. Eating behavior in response to acute stress. Rev Med Chir Soc Med Nat Iasi 2016; 120(2): 223-227.
13. Matos-Santos A, Lacerda Nobre E, Garcia E et al. Relationship between the number and impact of stressful life events and the onset of Graves’ Disease and toxic nodular goitre. Clin Endocrinol (Oxf) 2001; 55: 15-19.
14. Paunkovic N, Paunkovic J, Pavlovic O, Paunovic Z. The significant increase in incidence of Graves' disease in eastern Serbia during the civil war in the former Yugoslavia (1992 to 1995). Thyroid 1998; 8(1): 37-41.
15. Müssig K, Künle A, Säuberlich A et al. Thyroid peroxidase antibody positivity is associated with symptomatic distress in patients with Hashimoto’s thyroiditis. Brain Behav Immun 2012; 26: 559-563.
16. Traian MG, Coman AE, Popa E, Traian L, Petrovanu R. Stress: from symptom to disease. Rev Med Chir Soc Med Nat Iasi 2013; 117(1): 72-77.
17. Patacchioli FR, Ghiciuc CM, Bernardi M et al. Salivary α-amylase and cortisol after exercise in men-opause: influence of long-term HRT. Climacteric 2015; 18(4): 528-535.

Additional Files

Published

2017-09-30

Issue

Vol. 121 No. 3 (2017): The Medical-Surgical Journal

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INTERNAL MEDICINE - PEDIATRICS

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