Association of stress and primary hypothyroidism

Monika Singh; Jagdish Narayan; Ruchika Thakur; Sandeep Bhattacharya; Satyendra K Sonkar; Wahid Ali

doi:10.4103/jfmpc.jfmpc_845_23

Association of stress and primary hypothyroidism

J Family Med Prim Care. 2024 Mar;13(3):1073-1078. doi: 10.4103/jfmpc.jfmpc_845_23. Epub 2024 Apr 4.

Authors

Monika Singh¹, Jagdish Narayan¹, Ruchika Thakur¹, Sandeep Bhattacharya¹, Satyendra K Sonkar², Wahid Ali³

Affiliations

¹ Department of Physiology, King George's Medical University, Lucknow, Uttar Pradesh, India.
² Department of Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India.
³ Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India.

Abstract

Background: Hypothyroidism is the result of impaired production and secretion of thyroid hormones. The cardiovascular system is affected by fluctuations in thyroid hormone levels. Stressful events or stressors can affect the hypothalamic-pituitary-thyroid (HPT) axis and psychological and physiological responses. Stress increases thyroid hormone levels while decreasing TSH levels, which exacerbates autoimmune thyroid disease.

Aim: To evaluate the relationship between stress and primary hypothyroidism.

Methods: A total of 77 newly diagnosed hypothyroid patients (TSH >5.0 mIU/L) and 77 healthy adults (TSH 0.5-5.0 mIU/L) were enrolled. During a brief general physical examination, the following values were measured: height, weight, blood pressure, pulse, and pulse rate. A brief systemic examination of the cardiovascular system and lungs was also performed to rule out systemic diseases. Heart rate variability (HRV) processing and analysis were performed using Pro LabChart (PowerLab 8Pro) data analysis software from AD Instrument.

Results: Mean Avg. RR was significantly higher, RM SSD and pRR50 were significantly lower in cases than in controls. Mean HF was significantly lower and LF/HF (frequency range) was significantly higher in cases than in controls. Mean PSS was significantly higher in cases (25.82 ± 2.83) than in controls (22.47 ± 2.10). The majority of cases (54.5%) had a high stress level. The TSH level showed a highly significant correlation with the LF/HF ratio and with the PSS score.

Conclusion: The mean Avg. RR and HF were significantly higher, RM SSD and pRR50 and LF/HF (frequency range) were significantly lower in hypothyroid patients.

Keywords: Cardiovascular system; T3; T4; TSH; hypothyroidism; stress.