Aim: The aim of this study was to evaluate the effect of levothyroxine treatment on dyspeptic symptoms and gastric emptying time in patients with subclinical hypothyroidism.
Materials and Methods: Liquid gastric emptying scintigraphy was performed to detect the presence of gastroparesis in patients with dyspeptic complaints who were followed up with a diagnosis of subclinical hypothyroidism in the thyroid outpatient clinic. Those with specific hypothyroidism symptoms during their follow-up were treated with low dose (25 mg) levothyroxine for at least 6 months. Liquid gastric emptying scintigraphy test was performed again after treatment for those who continued to have dyspeptic complaints. Patients whose gastric emptying time was calculated using a liquid gastric emptying scintigraphy test before and after levothyroxine treatment were retrospectively examined. For testing, 18.5-37 MBq (0.5-1 mCi) 99m-TC nanocolloid was added to 300 ml of water. Late images were acquired at 30 minutes and one hour. The time activity curve was obtained.
Results: Gastric emptying was normal in 13 (23.6%) patients in the liquid gastric emptying scintigraphy test performed before treatment. After treatment, gastric emptying half-time was normalized in 34 (81%) of 42 (76.4%) patients with a long gastric emptying half-time before treatment. In total, 47 patients had normal gastric emptying half-time values after treatment, and gastric emptying half-time was calculated to be long in 8 patients (14.5%).
Conclusion: In our study, gastric emptying time was prolonged in 76.4% of patients with subclinical hypothyroidism, and in 81% of these patients, gastric emptying time was calculated within normal limits after LT4 treatment. Detection of prolongation of gastric emptying time due to the presence of gastroparesis in subclinical hypothyroidism cases followed up without treatment may be a guide in the prescription of treatment.
Key words: Subclinical hypothyroidism, levothyroxine, radionuclide imaging, gastric emptying time, gastroparesis
|
