Experiences of fatigue and depression before and after low-dose 1-thyroxine supplementation in essentially euthyroid individuals

Hypothyroidism is a relative state, long associated with fatigue and depression. Individuals may experience thyroid-related symptoms such as fatigue and depression before thyroid indices become abnormal. However, because of clinicians' diverse interpretations of appropriate circumstances for its use, low-dose, 1-thyroxine supplementation often is overlooked as a therapeutic agent for symptom treatment. The purpose of this exploratory, hermeneutic study was to describe euthyroid individuals' experiences of fatigue and depression before and after low-dose 1-thyroxine supplementation. For women participants, the collective influence of fatigue and depression prior to treatment interfered significantly with their day-to-day lives, despite their euthyroid status. For men, the influence of symptoms was far less substantial than for women. In general, participants responded favorably, both physically and emotionally, to low-dose 1-thyroxine supplementation. Furthermore, no participant experienced 1-thyroxine induced hyperthyroidism or untoward side effects attributable to 1-thyroxine. Further study of effects of 1-thyroxine on symptoms is needed. (C) 1997 John Wiley & Sons, Inc.