Women with Hashimoto’s thyroiditis suffer from a high symptom load that negatively affects their quality of life, even when thyroid function is normal, suggests a new study.

Hashimoto’s thyroiditis, also known as chronic autoimmune thyroiditis, is the most common cause of hypothyroidism, and most often affects middle-aged women. Symptoms include chronic fatigue, difficulty concentrating, chronic irritability, chronic nervousness, constipation, and dry hair.

The presence of antithyroperoxidase (anti-TPO) antibodies is characteristic of Hashimoto’s thyroiditis. Investigators hypothesized that higher levels of anti-TPO antibodies would be associated with an increased symptom load and a decreased quality of life in female patients with normal thyroid function. The prospective cohort study involved 426 euthyroid women undergoing thyroid surgery for benign thyroid disease (mean age 54.5 years).

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Histologic examination identified Hashimoto’s thyroiditis in 6.6% of the patients. Having calculated an anti-TPO cutoff point of 121.01 U/mL for the study, the researchers found the mean number of reported symptoms to be significantly higher in the women with anti-TPO levels >121.0 IU/mL than in women with lower levels (6.7 vs. 4.1). Chronic fatigue, dry hair, chronic irritability, chronic nervousness, a history of breast cancer and of early miscarriage, and lower quality-of-life levels were significantly associated with anti-TPO levels exceeding 121.0 IU/mL. There was no difference in preoperative thyroid-stimulating hormone levels between the two groups. Approximately 30% of the women in each group were in need of thyroid hormone supplementation.

“Women with [Hashimoto’s thyroiditis] suffer from a high symptom load,” wrote the researchers (Thyroid. 2011;21:161-167). “Hypothyroidism is only a contributing factor to the development of associated conditions.” Further research is recommended to improve or develop treatment strategies.