Hypothyroidism, Metabolism and Quality of Life - Focus on QOL, REE, Cognitive Function and Body Composition

Subjects and Methods:

74 newly diagnosed hypothyroid patients of both genders and age between 20 and 75 years will be recruited from the out-patients clinic in Herlev and Gentofte Hospital and the general practitioners before start of substitution therapy. Participants will get an appointment immediately after diagnosis to avoid unnecessary delay of treatment. Shortly after diagnosis patients will undergo a test panel at the first experimental day, where patients arrives fasting.

• Psychological test using:

• ThyPRO a thyroid-specific quality of life questionnaire(18),
• Cognitive function by CALCAP® Abbreviated Test Battery,
• Perceived cognitive deficit questionnaire (Perceived Deficits Questionaire)
• Major Depression Inventory (MDI) questionnaire
• REE will be measured by a CCM-express calorimeter,
• DEXA-scan
• Blood samples will be taken and patients will be characterized through basic information.
• Insulin resistance will be assess through an oral glucose tolerance test (OGTT) At end of the first experimental day patients will start L-T4 therapy following national guidelines, with regular control of thyroid hormones to ensure optimal treatment. When patients are euthyroid and TSH is below 4 * 10-3 International Units pr liter (mU/l) patients will have blood samples monitored every 3 months for the rest of the trial.

After 6 and 12 months of treatment patients will undergo a similar experimental day and return to their general practitioner or outpatient clinic.

A control group of 18 matched healthy persons will undergo the first experimental day in the same way as the hypothyroid patients, except they do not start any kind of therapy and they only participate in the first experimental day.

Inclusion criteria

• TSH > 10 mU/liter

Exclusion criteria

• Serious competing illness
• Pregnancy or planning to become pregnant
• Thyroidectomized patients
• Unable to speak and understand danish