Background: A significant portion of patients undergoing levothyroxine (LT4) therapy for hypothyroidism report a diminished quality of life compared to individuals without the condition. This observation raises questions about the effectiveness of current treatments and whether other factors contribute to this reduced well-being. To delve deeper into these concerns, an Online Survey was conducted to explore the experiences and satisfaction levels of hypothyroid patients, aiming to provide valuable data for discussions on improving hypothyroidism management.
Methods: An extensive online survey was strategically deployed to reach a broad spectrum of hypothyroid patients. The survey was hosted on the American Thyroid Association website, a reputable source for thyroid-related information, and further disseminated through various patient groups and online communities. Participants were asked to evaluate their satisfaction with their current hypothyroidism treatment and their healthcare provider using a ranking system. Crucially, the survey also gauged patient perceptions regarding their physician’s expertise in hypothyroidism treatments, the perceived necessity for innovative therapies, and the overall impact of hypothyroidism on their lives, all measured on a scale of 1 to 10. Respondents provided details about their prescribed therapy, categorized into LT4 monotherapy, combination therapy of LT4 and liothyronine (LT4 + LT3), or desiccated thyroid extract (DTE). Furthermore, demographic and clinical data were collected, including sex, age, cause of hypothyroidism, treatment duration, co-existing medical conditions, and the prevalence of specific hypothyroid symptoms.
Results: The online survey garnered responses from a substantial cohort of 12,146 individuals, providing a robust dataset for analysis. The median overall treatment satisfaction score was 5, with an interquartile range (IQR) of 3-8, indicating a considerable range in patient experiences. Focusing on a subset of respondents (n = 3670) who did not report depression, significant stressors, or other medical conditions, notable differences in treatment satisfaction emerged. Patients treated with DTE reported a significantly higher median treatment satisfaction score of 7 (IQR = 5-9) compared to other treatment modalities. In contrast, the LT4 monotherapy group exhibited the lowest median satisfaction score of 5 (IQR = 3-7), while the LT4 + LT3 combination therapy group reported a median satisfaction of 6 (IQR = 3-8). Interestingly, those using DTE were also less likely to report persistent challenges with weight management, fatigue and energy levels, mood disturbances, and memory impairment compared to individuals on LT4 or LT4 + LT3.
Conclusions: The findings from this online survey highlight that a notable segment of hypothyroid patients express dissatisfaction with their current treatment regimen and the care provided by their physicians. The consistently higher satisfaction reported by patients using DTE, regarding both treatment and physician, warrants further investigation. While the study design, based on an online survey, does not elucidate the underlying mechanisms for this observation, it underscores the need for future research. Specifically, subsequent studies should explore whether the apparent preference for DTE is linked to triiodothyronine (T3) levels, which DTE naturally contains, or other currently unidentified factors. These insights gained from this online survey are crucial for guiding future research and ultimately enhancing patient care in hypothyroidism.
