Association between thyroidea function and opioid agonist therapy: a prospective cohort study from Norway.

Area of Science:

• Endocrinology
• Pharmacology
• Public Health

Background:

• Opioid agonist therapy (OAT) is a cornerstone treatment for opioid dependency.
• While OAT can cause endocrinopathies affecting treatment tolerability, the impact on the thyroid axis is less understood compared to adrenal and gonadal axes.
• Long-term opioid use and associated risk factors may influence thyroid function, necessitating further investigation.

Purpose of the Study:

• To investigate the associations between thyroid function biomarkers and OAT medication.
• To explore relationships between thyroid function and sociodemographic, clinical factors, and concurrent illicit substance use in OAT patients.
• To determine if OAT influences thyroid axis regulation.

Main Methods:

• Prospective data from 320 patients receiving OAT in Bergen, Norway (2016-2023).
• Two health assessments including serum TSH measurements.
• Linear mixed-effects modeling to analyze associations between serum TSH and OAT medication, sociodemographic, and clinical factors over time.

Main Results:

• Median serum TSH was 1.8 mIU/L at the first assessment, within the recommended range.
• No significant associations were found between OAT medications, sociodemographic factors, or clinical variables and serum TSH levels.
• Thyroid function remained stable over time in the study population.

Conclusions:

• Median serum TSH levels were normal in patients undergoing OAT.
• No evidence of thyroid insufficiency was associated with OAT treatment.
• Routine thyroid function screening may not be required for OAT patients unless clinically indicated by symptoms.