EFFECT OF LEVOTHYROXINE ON CARPAL TUNNEL SYNDROME IN PRIMARY HYPOTHYROIDISM

Kadiyala Hinduja; B Vivekanand; A Mythili; Jayanthy Ramesh; K A V Subrahmanyam

Volume : IX, Issue : VI, June - 2019

EFFECT OF LEVOTHYROXINE ON CARPAL TUNNEL SYNDROME IN PRIMARY HYPOTHYROIDISM

Kadiyala Hinduja, B Vivekanand, A Mythili, Jayanthy Ramesh, K A V Subrahmanyam

Abstract :

Context: The prevalence of carpal tunnel syndrome(CTS) in hypothyroidism varies greatly in different studies ranging from 7 – 90%. There are very few studies evaluating the effect of levothyroxine on CTS in hypothyroidism. Aims: To estimate the prevalence of CTS in primary hypothyroidism(PH) at diagnosis and to compare the electrophysiological findings before and after levothyroxine replacement therapy(LRT). Materials and methods: 54 subjects aged above 18 years diagnosed with PH were included. Subjects were divided into mild, marked subclinical hypothyroidism(SCH) and overt hypothyroidism based on T4 and TSH. Nerve conduction studies including median motor and sensory nerves were performed at the onset of the study and after 3 months of LRT. Results: At the onset, electrophysiological evaluation revealed CTS in 11(20.4%) subjects of whom 10 had bilateral CTS. Of these 11 subjects, 7 were obese, 8 had marked SCH and 9 had TPOAb (thyroperoxidase antibody) positivity. After LRT only 5 had CTS. The differences between values of median motor distal latency, median sensory distal latency and conduction velocity before and after treatment were statistically significant. Conclusion: CTS was bilateral in 90%. CTS was more common in subjects who were obese and had marked SCH and TPOAb positivity. Normalisation of TSH with LRT significantly reversed the electrophysiological abnormalities