The impact of overt and subclinical hyperthyroidism on skeletal muscle

Michael D. Brennan, Claudia Powell, Kenton R Kaufman, Pi Chang Sun, Rebecca S. Bahn, K Sreekumaran Nair

Research output: Contribution to journalArticle

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Abstract

Objective: Patients with overt hyperthyroidism (OH) commonly have proximal limb muscle weakness that improves after correction of hyperthyroidism. It is unclear, however, if patients with milder degrees of hyperthyroidism (referred to as subclinical hyperthyroidism or SCH) may also have a degree of muscle weakness. This may have clinical relevance as SCH patients are often elderly and may therefore have concurrent sarcopenia of aging and would represent a previously unrecognized complication of SCH. Design: We measured both thigh strength and cross-sectional area in patients with OH (n = 30) or SCH (n = 24), both prior to treatment of hyperthyroidism and again at 6-9 months after the restoration of a euthyroid state. Euthyroid controls (n = 48) were studied at similar time intervals. Main outcome: Prior to treatment, both knee flexor and extensor muscle strength was reduced in both patients with OH and SCH compared to controls (p < 0.05). After treatment all strength measurements improved in the OH group (p < 0.01) while in the SCH group the majority of muscle strength measurements improved (p < 0.05). Midthigh muscle cross-sectional area was reduced in both the OH and SCH group at baseline (p < 0.05) compared to controls and increased significantly following treatment (p < 0.05). There were no significant changes in any parameter in the euthyroid control (EC) group during the study period. Conclusions: The finding that muscle strength and cross-sectional area are reduced in SCH and improved after treatment lends support for the clinical decision to treat rather than observe this condition. This may have particular relevance to certain SCH patient groups including the elderly who are prone to falls and athletically active younger patients who require optimal skeletal muscle function.

Original languageEnglish (US)
Pages (from-to)375-380
Number of pages6
JournalThyroid
Volume16
Issue number4
DOIs
StatePublished - Apr 2006

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Hyperthyroidism
Skeletal Muscle
Muscle Strength
Muscle Weakness
Clinical Decision Support Systems
Sarcopenia
Therapeutics
Thigh
Knee
Extremities
Muscles
Control Groups

ASJC Scopus subject areas

  • Endocrinology

Cite this

The impact of overt and subclinical hyperthyroidism on skeletal muscle. / Brennan, Michael D.; Powell, Claudia; Kaufman, Kenton R; Sun, Pi Chang; Bahn, Rebecca S.; Nair, K Sreekumaran.

In: Thyroid, Vol. 16, No. 4, 04.2006, p. 375-380.

Research output: Contribution to journalArticle

Brennan, Michael D. ; Powell, Claudia ; Kaufman, Kenton R ; Sun, Pi Chang ; Bahn, Rebecca S. ; Nair, K Sreekumaran. / The impact of overt and subclinical hyperthyroidism on skeletal muscle. In: Thyroid. 2006 ; Vol. 16, No. 4. pp. 375-380.
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AB - Objective: Patients with overt hyperthyroidism (OH) commonly have proximal limb muscle weakness that improves after correction of hyperthyroidism. It is unclear, however, if patients with milder degrees of hyperthyroidism (referred to as subclinical hyperthyroidism or SCH) may also have a degree of muscle weakness. This may have clinical relevance as SCH patients are often elderly and may therefore have concurrent sarcopenia of aging and would represent a previously unrecognized complication of SCH. Design: We measured both thigh strength and cross-sectional area in patients with OH (n = 30) or SCH (n = 24), both prior to treatment of hyperthyroidism and again at 6-9 months after the restoration of a euthyroid state. Euthyroid controls (n = 48) were studied at similar time intervals. Main outcome: Prior to treatment, both knee flexor and extensor muscle strength was reduced in both patients with OH and SCH compared to controls (p < 0.05). After treatment all strength measurements improved in the OH group (p < 0.01) while in the SCH group the majority of muscle strength measurements improved (p < 0.05). Midthigh muscle cross-sectional area was reduced in both the OH and SCH group at baseline (p < 0.05) compared to controls and increased significantly following treatment (p < 0.05). There were no significant changes in any parameter in the euthyroid control (EC) group during the study period. Conclusions: The finding that muscle strength and cross-sectional area are reduced in SCH and improved after treatment lends support for the clinical decision to treat rather than observe this condition. This may have particular relevance to certain SCH patient groups including the elderly who are prone to falls and athletically active younger patients who require optimal skeletal muscle function.

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