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Carpal Tunnel Syndrome in Hypothyroid Patients: The Effect of Hormone Replacement Therapy

Received: 9 May 2014     Accepted: 26 May 2014     Published: 20 June 2014
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Abstract

Objectives: To assess the electrodiagnostic evidence of median nerve dysfunction in newly diagnosed hypothyroid patients before and after hormone replacement therapy. Patients and methods: Fifty seven patients (fifty females and seven males) their age ranging from 23 to 61 years diagnosed with hypothyroidism,proved by thyroid hormone profile,were included in this study. Electrodiagnostic workup performed at the initial time of diagnosis and after 3 months including motor and sensory median nerve conduction studies in both right and left median nerves. Results: In our studied group, TSH levels were 30.77±23.51 IU/ mL before hormone replacement therapy and 5.25±1.72 IU/mL after the treatment. FT4 values were 9.2±1.54 pmol/l before treatment and 15.42±2.62pmol/l after treatment. FT3 levels were measured as 1.69±0.63Pmol/l at the diagnosis and 4.23±1.04 Pmol/l after treatment. The pre and post therapy levels difference of all previous parameters were statistically significant(P =0.001). Forty eight patients were normalized after treatment, while nine (13.8%) still had carpal tunnel syndrome symptoms. The differences between before treatment values of median nerve sensory and motor functions in both right and left median nerves respectively (sensory distal latency, sensory nerve conduction velocity, the sensory amplitude, the motor distal latency, the motor conduction velocity and the motor amplitude)(4.156±0.49 and 14.789±8.36 , 51.730±2.32 and 52.088±2.42, 28.123±8.52 and 25.193±5.74 , 4.404±0.66 and 4.393±0.61, 53.074±3.38 and 52.867±3.82 , 4.830±1.09 and 4.984±1.29 ) and after treatment values (3.365±0.44 and 3.561±0.46 , 63.649±2.16 and 63.035±3.56 , 33.123±7.16 and 29.280±5.39 , 3.674±0.52 and 3.767±0.46 , 64.193±2.79 and 63.789±4.00 , 5.368±1.18 and 5.488±1.19 ) were all significant (P =0.001). Conclusion: With hormonal replacement therapy, carpal tunnel syndrome can be reserved in patients with hypothyroidism within three months.

Published in American Journal of Internal Medicine (Volume 2, Issue 3)
DOI 10.11648/j.ajim.20140203.14
Page(s) 54-58
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2014. Published by Science Publishing Group

Keywords

Carpal Tunnel Syndrome, Hypothyroidism, Median Nerve

References
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    Arafat A. Kasem, Sabry M. Fathy, Doaa A. Shahin, Amir A. Fikry. (2014). Carpal Tunnel Syndrome in Hypothyroid Patients: The Effect of Hormone Replacement Therapy. American Journal of Internal Medicine, 2(3), 54-58. https://doi.org/10.11648/j.ajim.20140203.14

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    ACS Style

    Arafat A. Kasem; Sabry M. Fathy; Doaa A. Shahin; Amir A. Fikry. Carpal Tunnel Syndrome in Hypothyroid Patients: The Effect of Hormone Replacement Therapy. Am. J. Intern. Med. 2014, 2(3), 54-58. doi: 10.11648/j.ajim.20140203.14

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    AMA Style

    Arafat A. Kasem, Sabry M. Fathy, Doaa A. Shahin, Amir A. Fikry. Carpal Tunnel Syndrome in Hypothyroid Patients: The Effect of Hormone Replacement Therapy. Am J Intern Med. 2014;2(3):54-58. doi: 10.11648/j.ajim.20140203.14

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  • @article{10.11648/j.ajim.20140203.14,
      author = {Arafat A. Kasem and Sabry M. Fathy and Doaa A. Shahin and Amir A. Fikry},
      title = {Carpal Tunnel Syndrome in Hypothyroid Patients: The Effect of Hormone Replacement Therapy},
      journal = {American Journal of Internal Medicine},
      volume = {2},
      number = {3},
      pages = {54-58},
      doi = {10.11648/j.ajim.20140203.14},
      url = {https://doi.org/10.11648/j.ajim.20140203.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20140203.14},
      abstract = {Objectives: To assess the electrodiagnostic evidence of median nerve dysfunction in newly diagnosed hypothyroid patients before and after hormone replacement therapy. Patients and methods: Fifty seven patients (fifty females and seven males) their age ranging from 23 to 61 years diagnosed with hypothyroidism,proved by thyroid hormone profile,were included in this study. Electrodiagnostic workup performed at the initial time of diagnosis and after 3 months including motor and sensory median nerve conduction studies in both right and left median nerves. Results: In our studied group, TSH levels were 30.77±23.51 IU/ mL before hormone replacement therapy and 5.25±1.72 IU/mL after the treatment. FT4 values were 9.2±1.54 pmol/l before treatment and 15.42±2.62pmol/l after treatment. FT3 levels were measured as 1.69±0.63Pmol/l at the diagnosis and 4.23±1.04 Pmol/l after treatment. The pre and post therapy levels difference of all previous parameters were statistically significant(P =0.001). Forty eight patients were normalized after treatment, while nine (13.8%) still had carpal tunnel syndrome symptoms. The differences between before treatment values of median nerve sensory and motor functions in both right and left median nerves respectively (sensory distal latency, sensory nerve conduction velocity, the sensory amplitude, the motor distal latency, the motor conduction velocity and the motor amplitude)(4.156±0.49 and 14.789±8.36 , 51.730±2.32 and 52.088±2.42, 28.123±8.52 and 25.193±5.74 , 4.404±0.66 and 4.393±0.61, 53.074±3.38 and 52.867±3.82 , 4.830±1.09 and 4.984±1.29 ) and after treatment values (3.365±0.44 and 3.561±0.46 , 63.649±2.16 and 63.035±3.56 , 33.123±7.16 and 29.280±5.39 , 3.674±0.52 and 3.767±0.46  , 64.193±2.79 and 63.789±4.00 , 5.368±1.18 and 5.488±1.19 ) were all significant (P =0.001). Conclusion: With hormonal replacement therapy, carpal tunnel syndrome can be reserved in patients with hypothyroidism within three months.},
     year = {2014}
    }
    

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  • TY  - JOUR
    T1  - Carpal Tunnel Syndrome in Hypothyroid Patients: The Effect of Hormone Replacement Therapy
    AU  - Arafat A. Kasem
    AU  - Sabry M. Fathy
    AU  - Doaa A. Shahin
    AU  - Amir A. Fikry
    Y1  - 2014/06/20
    PY  - 2014
    N1  - https://doi.org/10.11648/j.ajim.20140203.14
    DO  - 10.11648/j.ajim.20140203.14
    T2  - American Journal of Internal Medicine
    JF  - American Journal of Internal Medicine
    JO  - American Journal of Internal Medicine
    SP  - 54
    EP  - 58
    PB  - Science Publishing Group
    SN  - 2330-4324
    UR  - https://doi.org/10.11648/j.ajim.20140203.14
    AB  - Objectives: To assess the electrodiagnostic evidence of median nerve dysfunction in newly diagnosed hypothyroid patients before and after hormone replacement therapy. Patients and methods: Fifty seven patients (fifty females and seven males) their age ranging from 23 to 61 years diagnosed with hypothyroidism,proved by thyroid hormone profile,were included in this study. Electrodiagnostic workup performed at the initial time of diagnosis and after 3 months including motor and sensory median nerve conduction studies in both right and left median nerves. Results: In our studied group, TSH levels were 30.77±23.51 IU/ mL before hormone replacement therapy and 5.25±1.72 IU/mL after the treatment. FT4 values were 9.2±1.54 pmol/l before treatment and 15.42±2.62pmol/l after treatment. FT3 levels were measured as 1.69±0.63Pmol/l at the diagnosis and 4.23±1.04 Pmol/l after treatment. The pre and post therapy levels difference of all previous parameters were statistically significant(P =0.001). Forty eight patients were normalized after treatment, while nine (13.8%) still had carpal tunnel syndrome symptoms. The differences between before treatment values of median nerve sensory and motor functions in both right and left median nerves respectively (sensory distal latency, sensory nerve conduction velocity, the sensory amplitude, the motor distal latency, the motor conduction velocity and the motor amplitude)(4.156±0.49 and 14.789±8.36 , 51.730±2.32 and 52.088±2.42, 28.123±8.52 and 25.193±5.74 , 4.404±0.66 and 4.393±0.61, 53.074±3.38 and 52.867±3.82 , 4.830±1.09 and 4.984±1.29 ) and after treatment values (3.365±0.44 and 3.561±0.46 , 63.649±2.16 and 63.035±3.56 , 33.123±7.16 and 29.280±5.39 , 3.674±0.52 and 3.767±0.46  , 64.193±2.79 and 63.789±4.00 , 5.368±1.18 and 5.488±1.19 ) were all significant (P =0.001). Conclusion: With hormonal replacement therapy, carpal tunnel syndrome can be reserved in patients with hypothyroidism within three months.
    VL  - 2
    IS  - 3
    ER  - 

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Author Information
  • Department of Internal medicine, Faculty of Medicine, Al Azhar University, Cairo, Egypt

  • Department of Neurology, Faculty of Medicine, Al Azhar University, Cairo, Egypt

  • Clinical Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

  • Department of Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt

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