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Hypothyroidism. A reversible cause of diaphragmatic dysfunction.
F J Martinez1, M Bermudez-Gomez, B R Celli
1Department of Pulmonary Medicine, Boston Veterans Administration Medical Center.
Chest
|November 1, 1989
Summary
Hypothyroidism can cause diaphragm dysfunction, leading to breathing problems and fatigue. Thyroid hormone replacement therapy effectively reverses this diaphragmatic weakness and improves respiratory function.
Area of Science:
- Endocrinology
- Pulmonology
- Neuromuscular Disorders
Background:
- Peripheral myopathy is a known complication of hypothyroidism.
- Diaphragmatic involvement in hypothyroidism has been suggested but not well-defined clinically.
Purpose of the Study:
- To define the clinical spectrum and severity of diaphragmatic dysfunction in hypothyroidism.
- To assess the impact of thyroid hormone replacement on diaphragmatic function and respiratory parameters.
Main Methods:
- Studied three hypothyroid patients with respiratory symptoms.
- Measured maximal transdiaphragmatic pressure and diaphragmatic tension time index before and after treatment.
- Monitored arterial carbon dioxide levels (PaCO2), lung volumes, and exercise endurance.
Main Results:
- All patients exhibited low diaphragmatic strength and a fatiguing breathing pattern.
- Thyroid hormone replacement significantly improved diaphragmatic strength and reduced the tension time index.
- Respiratory symptoms, including chronic alveolar hypoventilation, were corrected, and lung volumes and exercise tolerance improved.
Conclusions:
- Diaphragmatic dysfunction is a frequent and potentially severe complication of hypothyroidism.
- This dysfunction is reversible with adequate thyroid hormone replacement therapy.