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Effect of L-Thyroxine Therapy on Musculoskeletal Symptoms of Hypothyroidism

Fathia Ehmouda Zaid, Emhmmed Eljazwi and Najat Eldrasi

Introduction: Hypothyroid rheumatic syndromes, ranging from myalgia and arthralgia to true myopathy and arthritis are due to thyroid dysfunction. Our purpose was to assess the effect of L-thyroxine therapy on musculoskeletal symptoms.

Patients and methods: A follow up study was done which included patients diagnosed with hypothyroidism and a history of musculoskeletal symptoms. They were interviewed with a structured questionnaire about their past and current musculoskeletal complaints, undergoing follow-up assessment from 3 to 12 months from baseline. The data was analyzed statistically. The correlation between recovery musculoskeletal symptoms on L-thyroxine therapy and various variable factors of hypothyroidism was evaluated by Pearson's correlation coefficient. A value of p<0.05 was considered significant.

Results: Seventy five patients diagnosed with hypothyroidism had musculoskeletal symptoms the musculoskeletal of hypothyroidism, most patients had arthralgia (72%), carpal tunnel syndrome (61.3%), frozen shoulder (37.3%), myalgia (36%), myopathy (12%) and arthritis (10.6%) the connective tissue disease association with hypothyroidism, patients had rheumatoid arthritis (14.7%), osteoarthritis (17.3%), fibromyalgia (13.3%) and systemic lupus erythematosus (2.7%). The management of musculoskeletal symptoms patients were start l thyroxine therapy (33.3%), patients were on same dose of l thyroxine (20%), patients were increase dose of l thyroxine (46.7%). Patients were given non-steroidal anti-inflammatory drugs (49.3%), physiotherapy (38.7%) and were undergone with reduction of weight (25.9%). Some musculoskeletal symptoms disappeared (66.7%), while some were unrecovered (33.3%). The strong correlation between recovery musculoskeletal symptoms of hypothyroidism and various variable factors like age, duration of hypothyroidism disease, co morbidity diseases and level TSH.

Conclusion: The musculoskeletal symptoms of hypothyroidism were improved by L-thyroxine treatment.