Assessment of the quality of life in patients with differentiated thyroid carcinoma during a one-month withdrawal of levorotatory thyroxine preparations (L-T4) before a control diagnostics

Abstract

Introduction: Monitoring of patients with differentiated thyroid carcinoma consists of a periodic control for thyroglobulin (Tg) concentration and radioiodine diagnostics during stimulation of endogenous TSH. Application of recombinant TSH is an alternative procedure which considerably increases cost of diagnostics but allows to avoid symptoms of hypothyreosis. This work was aimed at evaluating the influence of a withdrawal of L-T4 preparations preceding the control diagnostics on the quality of life in patients.
Material and methods: Investigation was performed in a group of 131 patients [115 women (87.75%) and 16 men (12.25%)] with differentiated thyroid carcinoma admitted for a periodic control diagnostics that included neck ultrasonography and an evaluation of Tg concentration, wholebody scintigraphy following a stimulation of endogenous TSH after a one-month break in taking L-T4 preparations. Research was conducted with a prepared questionnaire assessing several basic determinants of the quality of life on a 6-degree scale.
Results: During hypothyreosis quality of life in patients with differentiated thyroid carcinoma is worsened. The frequency and volume of symptoms increased twice.
Conclusions: 1. One-month gap in taking L-T4 is associated with a significant deterioration of the quality of life in tested patients.
2. The symptoms are especially strongly expressed in the elderly.
3. Administration of recombinant TSH (rhTSH) for a control diagnostics may permit the patients with differentiated thyroid carcinoma to avoid a deterioration of the quality of life.