Gender differences in symptoms of hypothyroidism: a population-based DanThyr study

ObjectivesWe examined the gender-specific symptom prevalences in hypothyroidism and in healthy controls and explored the extent to which symptoms indicative of thyroid status may be different in women and men. Design and MethodsPatients newly diagnosed with overt autoimmune hypothyroidism (n=140) and controls free of thyroid disease (n=560) recruited from the same population participated in a population-based study of The Danish Investigation of Iodine Intake and Thyroid Diseases (DanThyr). Participants underwent a comprehensive programme including blood tests and completion of questionnaires. The gender-specific distribution of 13 hypothyroidism-associated symptoms and a simple combined score (0-13) was explored in conditional uni- and multivariate models taking into account a broad spectrum of possible confounders. Diagnostic odds ratios (DORs) were calculated as measures for the association between participant status (case vs control) and presence of symptoms (yes vs no). ResultsIn overt autoimmune hypothyroidism, 949% of women and 913% of men (P=062) reported at least one of the hypothyroidism-associated symptoms, with tiredness as the most common symptom followed by dry skin and shortness of breath. In contrast, women free of thyroid disease self-reported at least one hypothyroidism-associated symptom considerably more often than men (737% vs 511%, P<0001). DORs (SEM) for 0-1/2-3/4-13 symptoms were 007 (004-010)/215 (157-294)/799 (615-104) in men and 021 (016-028)/062 (058-066)/199 (190-209) in women. ConclusionThe presence of symptoms is more indicative for overt autoimmune hypothyroidism in men than in women, and presumably persistent symptoms after therapy of hypothyroidism will be more common in women.