The effects of levothyroxine replacement or suppressive therapy on health status, mood, and cognition

Mary Samuels, Irina Kolobova, Anne Smeraglio, Dawn Peters, Jeri S. Janowsky, Kathryn Schuff

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Context: TSH-suppressive doses of levothyroxine (L-T4) have adverse effects on bone and cardiac function, but it is unclear whether central nervous system function is also affected. Objective: The aim of the study was to determine whether women receiving TSH-suppressive L-T4 doses have decrements in health status, mood, or cognitive function. Design and Setting: A cross-sectional comparison was made among three groups of women in an academic medical center research clinic. Patients: Twenty-four women receiving chronic TSH-suppressive L-T4 doses, 35 women receiving chronic replacement L-T4 doses, and 20 untreated control women participated in the study. Interventions: Subjects underwent testing at a single outpatient visit. Main Outcome Measures: We measured health status (SF-36), mood (Profile of Mood States, Symptom Checklist 90-R, Affective Lability Scale), and cognitive function (declarative memory [Paragraph Recall], working memory [N-back, Subject Ordered Pointing], motor learning [Pursuit Rotor, Motor Sequence Learning Test], and executive function [Letter Cancellation Test, Trail Making Test, Iowa Gambling Test]). Results: Women receiving TSH-suppressive or replacement L-T4 doses had decrements in health status and mood compared to healthy controls. These decrements were more pronounced in women receiving replacement, rather than suppressive, L-T4 doses. Memory and executive function were not affected in either treated group, compared to healthy controls. Conclusions: Women receiving TSH-suppressive doses of L-T4 do not have central nervous system dysfunction due to exogenous subclinical thyrotoxicosis, but TSH-suppressed and L-T4-replaced women have slight decrements in health status and mood that may be related to self-knowledge of the presence of a thyroid condition or other uncharacterized factors. These mood alterations do not impair cognitive function.

Original languageEnglish (US)
Pages (from-to)843-851
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Volume99
Issue number3
DOIs
StatePublished - 2014

Fingerprint

Thyroxine
Cognition
Health Status
Health
Neurology
Data storage equipment
Therapeutics
Executive Function
Central Nervous System
Learning
Trail Making Test
Gambling
Thyrotoxicosis
Bone
Checklist
Rotors
Short-Term Memory
Biomedical Research
Thyroid Gland
Outpatients

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

Cite this

The effects of levothyroxine replacement or suppressive therapy on health status, mood, and cognition. / Samuels, Mary; Kolobova, Irina; Smeraglio, Anne; Peters, Dawn; Janowsky, Jeri S.; Schuff, Kathryn.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 99, No. 3, 2014, p. 843-851.

Research output: Contribution to journalArticle

@article{053ee624dca646a2826d5016103d02f1,
title = "The effects of levothyroxine replacement or suppressive therapy on health status, mood, and cognition",
abstract = "Context: TSH-suppressive doses of levothyroxine (L-T4) have adverse effects on bone and cardiac function, but it is unclear whether central nervous system function is also affected. Objective: The aim of the study was to determine whether women receiving TSH-suppressive L-T4 doses have decrements in health status, mood, or cognitive function. Design and Setting: A cross-sectional comparison was made among three groups of women in an academic medical center research clinic. Patients: Twenty-four women receiving chronic TSH-suppressive L-T4 doses, 35 women receiving chronic replacement L-T4 doses, and 20 untreated control women participated in the study. Interventions: Subjects underwent testing at a single outpatient visit. Main Outcome Measures: We measured health status (SF-36), mood (Profile of Mood States, Symptom Checklist 90-R, Affective Lability Scale), and cognitive function (declarative memory [Paragraph Recall], working memory [N-back, Subject Ordered Pointing], motor learning [Pursuit Rotor, Motor Sequence Learning Test], and executive function [Letter Cancellation Test, Trail Making Test, Iowa Gambling Test]). Results: Women receiving TSH-suppressive or replacement L-T4 doses had decrements in health status and mood compared to healthy controls. These decrements were more pronounced in women receiving replacement, rather than suppressive, L-T4 doses. Memory and executive function were not affected in either treated group, compared to healthy controls. Conclusions: Women receiving TSH-suppressive doses of L-T4 do not have central nervous system dysfunction due to exogenous subclinical thyrotoxicosis, but TSH-suppressed and L-T4-replaced women have slight decrements in health status and mood that may be related to self-knowledge of the presence of a thyroid condition or other uncharacterized factors. These mood alterations do not impair cognitive function.",
author = "Mary Samuels and Irina Kolobova and Anne Smeraglio and Dawn Peters and Janowsky, {Jeri S.} and Kathryn Schuff",
year = "2014",
doi = "10.1210/jc.2013-3686",
language = "English (US)",
volume = "99",
pages = "843--851",
journal = "Journal of Clinical Endocrinology and Metabolism",
issn = "0021-972X",
publisher = "The Endocrine Society",
number = "3",

}

TY - JOUR

T1 - The effects of levothyroxine replacement or suppressive therapy on health status, mood, and cognition

AU - Samuels, Mary

AU - Kolobova, Irina

AU - Smeraglio, Anne

AU - Peters, Dawn

AU - Janowsky, Jeri S.

AU - Schuff, Kathryn

PY - 2014

Y1 - 2014

N2 - Context: TSH-suppressive doses of levothyroxine (L-T4) have adverse effects on bone and cardiac function, but it is unclear whether central nervous system function is also affected. Objective: The aim of the study was to determine whether women receiving TSH-suppressive L-T4 doses have decrements in health status, mood, or cognitive function. Design and Setting: A cross-sectional comparison was made among three groups of women in an academic medical center research clinic. Patients: Twenty-four women receiving chronic TSH-suppressive L-T4 doses, 35 women receiving chronic replacement L-T4 doses, and 20 untreated control women participated in the study. Interventions: Subjects underwent testing at a single outpatient visit. Main Outcome Measures: We measured health status (SF-36), mood (Profile of Mood States, Symptom Checklist 90-R, Affective Lability Scale), and cognitive function (declarative memory [Paragraph Recall], working memory [N-back, Subject Ordered Pointing], motor learning [Pursuit Rotor, Motor Sequence Learning Test], and executive function [Letter Cancellation Test, Trail Making Test, Iowa Gambling Test]). Results: Women receiving TSH-suppressive or replacement L-T4 doses had decrements in health status and mood compared to healthy controls. These decrements were more pronounced in women receiving replacement, rather than suppressive, L-T4 doses. Memory and executive function were not affected in either treated group, compared to healthy controls. Conclusions: Women receiving TSH-suppressive doses of L-T4 do not have central nervous system dysfunction due to exogenous subclinical thyrotoxicosis, but TSH-suppressed and L-T4-replaced women have slight decrements in health status and mood that may be related to self-knowledge of the presence of a thyroid condition or other uncharacterized factors. These mood alterations do not impair cognitive function.

AB - Context: TSH-suppressive doses of levothyroxine (L-T4) have adverse effects on bone and cardiac function, but it is unclear whether central nervous system function is also affected. Objective: The aim of the study was to determine whether women receiving TSH-suppressive L-T4 doses have decrements in health status, mood, or cognitive function. Design and Setting: A cross-sectional comparison was made among three groups of women in an academic medical center research clinic. Patients: Twenty-four women receiving chronic TSH-suppressive L-T4 doses, 35 women receiving chronic replacement L-T4 doses, and 20 untreated control women participated in the study. Interventions: Subjects underwent testing at a single outpatient visit. Main Outcome Measures: We measured health status (SF-36), mood (Profile of Mood States, Symptom Checklist 90-R, Affective Lability Scale), and cognitive function (declarative memory [Paragraph Recall], working memory [N-back, Subject Ordered Pointing], motor learning [Pursuit Rotor, Motor Sequence Learning Test], and executive function [Letter Cancellation Test, Trail Making Test, Iowa Gambling Test]). Results: Women receiving TSH-suppressive or replacement L-T4 doses had decrements in health status and mood compared to healthy controls. These decrements were more pronounced in women receiving replacement, rather than suppressive, L-T4 doses. Memory and executive function were not affected in either treated group, compared to healthy controls. Conclusions: Women receiving TSH-suppressive doses of L-T4 do not have central nervous system dysfunction due to exogenous subclinical thyrotoxicosis, but TSH-suppressed and L-T4-replaced women have slight decrements in health status and mood that may be related to self-knowledge of the presence of a thyroid condition or other uncharacterized factors. These mood alterations do not impair cognitive function.

UR - http://www.scopus.com/inward/record.url?scp=84895785719&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84895785719&partnerID=8YFLogxK

U2 - 10.1210/jc.2013-3686

DO - 10.1210/jc.2013-3686

M3 - Article

VL - 99

SP - 843

EP - 851

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

SN - 0021-972X

IS - 3

ER -