The effect of iatrogenic subclinical hyperthyroidism on anxiety, depression and quality of life in differentiated thyroid carcinoma

Abstract

Background/aim: Overt thyroidism is known to cause neuropsychiatric disorders but studies on subclinical hyperthyroidism SCH are limited. Subclinical hyperthyroidism induction by administering L-Thyroxine LT4 is the standard treatment method in differentiated thyroid carcinoma DTC follow-up. Our aim was to investigate whether anxiety, depression and quality of life are affected in DTC patients followed-up with exogenous SCH. Materials and methods: The patients were divided into exogenous SCH by LT4-DTC n = 127 , euthyroid-DTC n = 66 and exogenous euthyroid-benign thyroid noduüle BTN who underwent thyroidectomy for benign thyroid pathology n = 85 groups. Results: The rate of moderate/severe anxiety was significantly higher in SCH-DTC than euthyroid-BTN group 27.5%, n = 35 vs. 9.4%, n = 8 P = 0.001 . TSH levels and Beck anxiety inventory BAI scores were significantly negatively correlated P = 0.009 r = -0.16 . Free T4 and BAI were significantly positively correlated P = 0.04 r = 0.4 . The groups were similar in terms of depression severity P = 0.15 . Subclinical hyperthyroid-DTC group scored significantly lowerthan euthyroid-BTN group in all scales of SF-36 quality of life survey. Conclusion: LT4-induced SCH, which is a part of traditional DTC treatment, can exacerbate the anxiety symptoms in patients and disrupt their quality of life, depending on the level of fT4.