Prevalence of Thyroid Function Abnormalities and Its Association with Physical Fatigue in First-Year Medical Students
Arindam Ghosh, Debdeep Dasgupta, Susumna Biswas
Abstract
Objective: To estimate prevalence and type of thyroid function abnormalities and explore their associations with physical fatigue in first-year medical students.
Methods: This was a cross-sectional observational study comprising of 200 first-year medical students. Demographic details and history of any significant medical illness was asked and noted. Thyroid function tests were conducted on all participants. The prevalence and type of thyroid function abnormalities were documented in all students, and the presence and severity of physical fatigue were assessed on the basis of physical fatigue score. Participants with any kind of thyroid function abnormality were compared with those with normal thyroid function tests for presence and severity of fatigue.
Results: Among the 200 students, 144 (72%) were males and 56 (28%) were females, resulting in a male-to-female ratio of 1:0.38. Subclinical hypothyroidism was identified in 9% of students (18 cases), while clinical hypothyroidism was present in 7% (14 cases). Additionally, subclinical hyperthyroidism was detected in 1% of students (2 cases), with no cases of clinical hyperthyroidism reported. Female students were found to be having more thyroid function abnormalities as compared to male students and the difference was found to be statistically significant (p=0.0109). Students with abnormal thyroid function tests (34 cases) had a markedly higher mean FSS score (43.22±4.50) as compared to students with euthyroid (16.85±2.70).
Conclusion: Subclinical thyroid abnormalities are prevalent among young individuals, particularly those with physical fatigue. This study revealed a significant link between presence of fatigue and the possibility of thyroid dysfunction.
Keywords
Physical fatigue, subclinical hypothyroidism, thyroid function abnormalities, thyroid function test
Müller P, Leow MK, Dietrich JW. Minor perturbations of thyroid homeostasis and major cardiovascular endpoints-Physiological mechanisms and clinical evidence. Front Cardiovasc Med. 2022;9:942971. Published 2022 Aug 15. doi:10.3389/fcvm.2022.942971
Robles-Osorio ML, Zacarías-Rangel V, García-Solís P, Hernández-Montiel HL, Solís JC, Sabath E. Prevalence of thyroid function test abnormalities and anti-thyroid antibodies in an open population in Central México. Rev Invest Clin. 2014;66(2):113–20.
Samuels MH. Psychiatric and cognitive manifestations of hypothyroidism. Curr Opin Endocrinol Diabetes Obes. 2014;21(5):377–83. doi:10.1097/MED.0000000000000089
Paschou SA, Bletsa E, Stampouloglou PK, Tsigkou V, Valatsou A, Stefanaki K, et al. Thyroid disorders and cardiovascular manifestations: an update. Endocrine. 2022;75(3):672–83. doi:10.1007/s12020-022-02982-4
Bardugo A, Derazne E, Zucker I, Bendor CD, Puris G, Lutski M, et al. Adolescent thyroid disorders and risk for type 2 diabetes in young adulthood. J Clin Endocrinol Metab. 2021;106(9):e3426–e3435. doi:10.1210/clinem/dgab382
Xie Y, Wang Z, Chen Z. Analysis of subclinical thyroid dysfunction and metabolic abnormality in 28568 Healthy People. Int J Endocrinol. 2023;2023:5216945. Published 2023 Oct 16. doi:10.1155/2023/5216945
Galland-Decker C, Marques-Vidal P, Vollenweider P. Prevalence and factors associated with fatigue in the Lausanne middle-aged population: a population-based, cross-sectional survey. BMJ Open. 2019;9(8):e027070. doi:10.1136/bmjopen-2018-027070
Manolis AA, Manolis TA, Melita H, Manolis AS. Subclinical thyroid dysfunction and cardiovascular consequences: An alarming wake-up call?. Trends Cardiovasc Med. 2020;30(2):57–69. doi:10.1016/j.tcm.2019.02.011
Zamwar UM, Muneshwar KN. Epidemiology, Types, Causes, Clinical Presentation, Diagnosis, and Treatment of Hypothyroidism. Cureus. 2023;15(9):e46241. doi:10.7759/cureus.46241
Mullur R, Liu YY, Brent GA. Thyroid hormone regulation of metabolism. Physiol Rev. 2014;94(2):355–82. doi:10.1152/physrev.00030.2013
Iqbal A, Azhar S, Murtaza G, Bibi R, Samreen S, Iqbal MM, Syed W, Al-Rawi MBA. Navigating thyroid dysfunction and comorbidities among University Students in Abbottabad, Pakistan-a cross-sectional evaluation of screening tool for thyroid dysfunction. Int J Gen Med. 2023;16:4193–205. doi: 10.2147/IJGM.S415311. PMID: 37731899; PMCID: PMC10508279.
Wanjari M, Patil M, Late S, Umate R. Prevalence of thyroid disorder among young adults in the rural areas of Wardha district: A cross-sectional study. J Family Med Prim Care. 2022 Dec;11(12):7700–4. doi: 10.4103/jfmpc.jfmpc_806_22. Epub 2023 Jan 17. PMID: 36994012; PMCID: PMC10041002.
Delshad H, Mehran L, Tohidi M, Assadi M, Azizi F. The incidence of thyroid function abnormalities and natural course of subclinical thyroid disorders, Tehran, I.R. Iran. J Endocrinol Invest. 2012 May;35(5):516–21. doi: 10.3275/7968. Epub 2011 Sep 30. PMID: 21971483.
Unnikrishnan AG, Kalra S, Sahay RK, Bantwal G, John M, Tewari N. Prevalence of hypothyroidism in adults: An epidemiological study in eight cities of India. Indian J Endocrinol Metab. 2013;17(4):647–52. doi:10.4103/2230-8210.113755
Meng Z, Liu M, Zhang Q, Liu L, Song K, Tan J, et al. Gender and Age Impacts on the Association Between Thyroid Function and Metabolic Syndrome in Chinese. Medicine (Baltimore). 2015;94(50):e2193. doi:10.1097/MD.0000000000002193
Olmos RD, Figueiredo RC, Aquino EM, Lotufo PA, Bensenor IM. Gender, race and socioeconomic influence on diagnosis and treatment of thyroid disorders in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Braz J Med Biol Res. 2015;48(8):751–8. doi:10.1590/1414-431X20154445
Fischer S, Markert C, Strahler J, Doerr JM, Skoluda N, Kappert M, Nater UM. Thyroid functioning and fatigue in women with functional somatic syndromes - role of early life adversity. Front Physiol. 2018;9:564. doi: 10.3389/fphys.2018.00564. PMID: 29875680; PMCID: PMC5974249.
Ruíz-Pacheco MG, Hernández I, Hernández-Estrella G, Basurto L, Vargas-Ortega G, González-Virla B, et al. Severity of fatigue and its relationship with tsh before and after levothyroxine replacement therapy in patients with primary hypothyroidism. Biomedicines. 2023;11(3):811. doi: 10.3390/biomedicines11030811. PMID: 36979787; PMCID: PMC10045891.
Stuber MJ, Moutzouri E, Feller M, Del Giovane C, Bauer DC, Blum MR, et al. Effect of thyroid hormone therapy on fatigability in older adults with subclinical hypothyroidism: a nested study within a randomized placebo-controlled trial. J Gerontol A Biol Sci Med Sci. 2020;75(9):e89–e94. doi: 10.1093/gerona/glaa123. PMID: 32577745; PMCID: PMC7494024.