Therapeutic flow chart: Proposed algorithm for the treatment of syndrome T (SORSHOT). The approach includes optimising dosage and modality of treatment, considering treatment with L-T3, treating common and important comorbidities and correcting mineral and vitamin D deficiencies.

#Syndrome_T, i.e. persistent symptoms and reduced #QoL despite normal #TSH concentration, affects 10% of #hypothyroid patients on #levothyroxine. Careful, multimodal and personalised treatment can result in significantly improved outcomes.

#hypothyroidism #thyroid #SORSHOT

doi.org/10.1007/978-...

Scatterplots showing a significant correlation of functional parameters of thyroid homeostasis (SPINA-GT and SPINA-GD) with the mechanical pain sensitivity (MPS) of QST (A), respiratory arrhythmia in HRV analysis (B) and depression percentiles in HADS (C).

Growing evidence supports a role of sensorimotor and autonomic #neuropathy in #syndrome_T or #SORSHOT, i.e. reduced quality of life in treated #hypothyroidism. #SPINA_GT and #SPINA_GD predict nerve function and depression.

pubmed.ncbi.nlm.nih.gov/38811750/

doi.org/10.1038/s415...

Bar plot showing a significant association of markers of respiratory arrhythmia with anti-TPO antibody titres. Shown are means ± SEM (bars and whiskers) as well as results of individual participants (dots)

Significant correlation of functional parameters of thyroid homeostasis with the mechanical pain sensitivity (MPS) of QST (A), respiratory arrhythmia in HRV analysis (B) and depression percentiles in HADS (C)

Should we, therefore, classify #syndrome_T as a psychosomatic disease? This would be premature and probably wrong. We found signs of sensorimotor and autonomic #neuropathy that depend on autoimmunity and #thyroid's secretory capacity (#SPINA_GT).

Bar and dot plots show that both anxiety and depression are more common in autoimmune thyroiditis compared to healthy controls.

Anxiety and depression in three zones of autoimmunity. p** < 0.01, **** < 1e−4, ***** < 1e−5 compared to group with low antibody titres (anti-TPO Ab < 60 U/mL).

Anxiety and depression in autoimmune thyroiditis depend on autoimmunity. Shown are HADS percentiles in three zones of antibody titres.

Our newest paper provides new insights into the conundrum of #syndrome_T / #SORSHOT. #Anxiety and #depression are significantly more common in autoimmune #thyroiditis compared to healthy controls. 🧪🩺

#thyroid #qol

doi.org/10.1038/s415...