Original Research Article
Year: 2020 | Month: February | Volume: 10 | Issue: 2 | Pages: 10-17
Link between Infertility, Overweight and Subclinical Hypothyroidism
Vikas Ratnaparkhe1, Harsh Shah2, Kavita Upadhyay3
1M.D Internal Medicine, Consultant Dept. Of Medicine, Dr. Hedgewar Hospital, Aurangabad
2D.N.B General Medicine (Dr. Hedgewar Hospital, Aurangabad)
3Resident D.N.B General Medicine, Dr. Hedgewar Hospital, Aurangabad
Corresponding Author: Kavita Upadhyay
ABSTRACT
Background: Subclinical hypothyroidism (SCH) is mild form of hypothyroidism. It is a biochemical condition associated with elevated serum TSH and normal free T4.
Reduced production of thyroid hormone is the hallmark of ‘Hypothyroidism’. Increased TSH level is the indicator of hypo-functioning of thyroid gland.
The prevalence of subclinical hypothyroidism in India ranges from 9% to 32 %. SCH is a silent disorder, likely to be missed. It can progress to overt hypothyroidism and aggravation of co-morbid clinical conditions like obesity and infertility if not treated.
Objective: To assess the various clinical presentations associated with SCH especially in relation with BMI, Infertility and lifestyle related disorders.
Materials and Methods: This was a prospective study of 200 adult patients diagnosed with SCH from January 2016 - June 2017 at Dr. Hedgewar hospital, Aurangabad.
Results: In our study the 63% of patients were females belonging to rural area (126 out of 200). Most of the SCH patients (37.5%) were from third and fourth decade and incidentally this is the most fertile period in the life of female. In our study, Infertility was recorded in 15.74% out of a total of 127 females of fertile age group. 80% females had BMI > 23 which is in the range of overweight, pre-obese and obese. In our study rural female preponderance was observed as regards the associated co-morbidities. In 67.5% patients with BMI > 23% we could establish the link between Female sex, obesity, dyslipidemia, infertility and SCH which needs further evaluation.
56% patients were symptomatic. The symptoms were Fatigue -56 %, weight gain - 34%, constipation - 30.5% and cold intolerance - 26%. Hypertension was present in 20% of cases and diabetes was found in 15% cases. Dyslipidemia was seen in 7.4% cases. Therefore, Obese fertile Females must be screened for SCH. 74.5% patients were treated with low dose levothyroxine.
Conclusion: SCH is a silent disorder. Strong clinical suspicion of SCH in female patients presenting with infertility and obesity is required. The incidence of SCH was more in rural female population.
80% of infertile females had BMI greater than or equal to 23. Treatment with low dose levothyroxine results in normalization of biochemical parameters and prevents progression of co-morbidities.
Key words: Sub-clinical hypothyroidism (SCH), Thyroid stimulating hormone (TSH) levothyroxine, obesity, infertility.