Quality of compensation and well-being of patients with primary hypothyroidism and obesity

Aim. The aim of the study was to compare quality of hypothyroidism compensation and well-being of patients with hypothyroidism with normal weight, overweight and obesity.

Methods. 306 patients with hypothyroidism on replacement therapy with L-T4 were included; of those 218 patients with compensated hypothyroidism. All patients were divided into groups depending on their body mass index: with normal body weight, overweight, obesity I and obesity II - III degree. We calculated the ideal body weight (IdBW) by Devine formula. Evaluation at baseline included: height, weight, BMI, quality of life (SF-36), TSQ, TSH, freeT3 (fT3), freeT4 (fT4) levels.

Results

There were no difference in the quality of compensation between groups of normal-weight, overweight and obese patients (p > 0,05). L-T4 dose in patients with obesity and overweight was significantly higher compared to normal-weight patients (p < 0,05). The L-T4 dose per 1 kg of actual body weight was significantly higher (p <0,001) in the normal-weight and overweight euthyroid patients compared to patients with obesity. In contrast, L-T4 dose per 1 kg of ideal body weight was significantly higher (p <0,001) in overweight (1.78 [1.52, 2.06]) and obese patients (1 9 [1.71, 2.4] 1.99 [1.72, 2.4]), as compared with normal-weight patients (1.49 [1.27, 1.78]). There were no correlation between the fT3, fT4 levels and weight, and also between the L-T4 dose and weight. QOL and TSQ levels were the same in the groups of normal-weight, overweight and obese patients (p>0,05).

Conclusions

The compensation of hypothyroidism in patients with overweight/obesity is not worse than that of normal-weight patients. The achievement of euthyroidism requires less L-T4 dose per 1 kg of the actual weight and significantly higher dose for 1 kg of ideal weight in obesity/overweight patients. 

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