Khalil, Mohammad Fitri (2020) Evaluation Of Difference In Levothyroxine Withdrawal Period And Its Effects On Thе Level Of Thyroid Stimulating Hormone And Quality Of Life In Differentiated Thyroid Carcinoma Patients. Masters thesis, Universiti Sains Malaysia.
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Abstract
Title: Evaluation of difference in levothyroxine withdrawal period and its effects on the level of thyroid stimulating hormone (TSH) and quality of life (QoL) in differentiated thyroid carcinoma patients. Introduction: Most patients with DTC require radioactive iodine (RAI) ablation therapy using 1-131. The preparation prior to RAI ablation includes withdrawal of levothyroxine for at least four weeks in order to raise the TSH level of more than 30 mIU/L. During 4 weeks of levothyroxine withdrawal, most patients develop symptoms of hypothyroidism. Reducing the period of levothyroxine withdrawal period from 4 weeks to 3 weeks could improve patient's overall health and QoL. Objective: To evaluate the difference in levothyroxine withdrawal period and its effect on the level of TSH and QoL. Methods: DTC patients who require RAI ablation therapy was recruited into this study. Thyroid function test and SF-36 questionnaire were conducted at week 3 and week 4 of levothyroxine withdrawal period. Clinical data was analysed using IBM SPSS version 26.0.0. Results: A total of 104 patients with the mean age of 47.06 years were recruited. Most of them were female (80.77%) and Malays (53.85%). Papillary thyroid carcinoma accounted for 77.88% of the patients. Stage 1 disease was the largest group with 67.31% whilst stage 3 was the smallest group with 6.73%. At week 3 of levothyroxine withdrawal, 88.46% of the patients were able to achieve TSH level of more than 30 mIU/L with means of 66.89 mIU/L, compared to 99.04% at week 4 of levothyroxine withdrawal. Cohen kappa measurement of agreement between week 3 and week 4 was 0.139. There was a significant reduction in the quality of life in week 4 compared to week 3 in all components (p <0.050). There were no significant association between the staging of the disease and TSH level at week 3 and week 4. Conclusion: 88.46% of the patients had achieved TSH level of more than 30 mIU/L after 3 weeks of levothyroxine withdrawal. However, 4 weeks of levothyroxine withdrawal is still more superior compared to 3 weeks. There was better QoL in the overall health and quality of life in week 3 compared to week 4.
| Item Type: | Thesis (Masters) |
|---|---|
| Subjects: | R Medicine |
| Divisions: | Institut Perubatan & Pergigian Termaju (Advanced Medical & Dental Institute (AMDI)) > Thesis |
| Depositing User: | NOR HASHIMY BIN ABDULLAH |
| Date Deposited: | 19 May 2026 02:32 |
| Last Modified: | 19 May 2026 02:32 |
| URI: | http://eprints.usm.my/id/eprint/64234 |
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