Post-Levothyroxine Thyroid Dysfunction in Saudi Arabian Patients with Hypothyroidism: A Cross-Sectional Study

Area of Science:

• Endocrinology
• Internal Medicine
• Clinical Chemistry

Background:

• Thyroid dysfunction management post-L-thyroxine (L-T4) treatment presents ongoing clinical challenges.
• These challenges are particularly noted in Middle Eastern populations, necessitating localized research.

Purpose of the Study:

• To evaluate the outcomes of L-T4 treatment for hypothyroidism in a Saudi Arabian population.
• To identify factors associated with persistent or emergent thyroid dysfunction (dysthyroidism) after treatment.

Main Methods:

• A descriptive, cross-sectional study was conducted in 2023 involving 163 patients on L-T4 for hypothyroidism.
• Measurements included thyroid hormones, lipid profiles, and 25-hydroxyvitamin D (25OH-D).
• Statistical analyses were performed to correlate clinical and biochemical parameters with treatment outcomes.

Main Results:

• Only 57% of patients achieved euthyroid status; 12.3% developed hyperthyroidism and 30.7% hypothyroidism post-treatment.
• Older age was significantly associated with dysthyroidism (p=0.018).
• Dyslipidemia, particularly elevated total cholesterol and LDLc, correlated with TSH levels, while elevated triglycerides were linked to post-thyroxine treatment (PTT) hyperthyroidism.

Conclusions:

• The observed rates of PTT hypo- and hyperthyroidism align with international findings.
• Age is a significant factor in dysthyroidism, and dyslipidemia is a consistent biochemical marker of suboptimal thyroid status.
• No significant association was found between PTT dysthyroidism and hypovitaminosis D or BMI in this cohort.