Abstract
Objective
Hypothyroidism often remains undetected because of the difficulty associating symptoms with disease. To determine the relation between symptoms and biochemical disease, we assessed symptoms and serum thyroid function tests, concurrently, for patients with and without hypothyroidism.
Design
Cross-sectional study.
Setting/Patients
Seventy-six newly diagnosed case patients with overt hypothyroidism and 147 matched control patients identified through outpatient laboratories in Michigan and Colorado.
Measurements and main results
Patient symptoms were assessed by questionnaire. Case patients reported a higher proportion of hypothyroid symptoms than did control patients (30.2% vs 16.5%,p<.0001). Univariate analysis identified three significant predictors of an elevated level of thyroid-stimulating hormone (TSH) (p<.05), and 13 symptoms which, when they had changed in the past year, were reported more often by case patients with hypothyroidism than by control patients (p<.005). Individuals reporting changes in 7 or more symptoms were significantly more likely to have hypothyroidism (likelihood ratio [LR]=8.7, 95% confidence interval [CI] 3.8, 20.2); those reporting changes in 2 or fewer symptoms were less likely to have hypothyroidism (LR=0.5, 95% CI 0.4, 0.7).
Conclusions
In this sample, the number of hypothyroid symptoms reported was directly related to the level of TSH. The association was stronger when more symptoms were reported. Symptoms that had changed in the past year were more powerful than symptoms reported present at the time of testing. This suggests that traditional symptoms are valuable when deciding which patients to test for hypothyroidism.
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The pilot to this study was presented as a poster at the regional meeting of the Society of General Internal Medicine, September 1995. The results of this study were presented as a poster at the annual meeting of the Society for Medical Decision Making, October 1996.
Supported by the General Clinical Research Center via U.S. Public Health Service Research Grant RR-00051 from the Division of Research Resources at the University of Colorado Health Sciences Center, and a Butterworth Foundation grant, Butterworth Hospital, Grand Rapids, Mich.
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Canaris, G.J., Steiner, J.F. & Ridgway, E.C. Do traditional symptoms of hypothyroidism correlate with biochemical disease?. J GEN INTERN MED 12, 544–550 (1997). https://doi.org/10.1046/j.1525-1497.1997.07109.x
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DOI: https://doi.org/10.1046/j.1525-1497.1997.07109.x