A Cross-sectional Study of Prevalence of Adrenal Insufficiency in Patients with Primary Autoimmune Hypothyroidism in a Tertiary Hospital, India

Objectives: This study aimed to assess the prevalence of adrenal insufficiency in patients with primary hypothyroidism who continued to be symptomatic despite adequate biochemical correction of hypothyroidism with synthetic levothyroxine. Methods: This cross-sectional study included 160 patients age...

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Main Authors: Paramjit Kaur Saini, Jubbin Jagan Jacob, Navjot Singh
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-03-01
Series:APIK Journal of Internal Medicine
Subjects:
Online Access:https://journals.lww.com/10.4103/ajim.ajim_68_24
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author Paramjit Kaur Saini
Jubbin Jagan Jacob
Navjot Singh
author_facet Paramjit Kaur Saini
Jubbin Jagan Jacob
Navjot Singh
author_sort Paramjit Kaur Saini
collection DOAJ
description Objectives: This study aimed to assess the prevalence of adrenal insufficiency in patients with primary hypothyroidism who continued to be symptomatic despite adequate biochemical correction of hypothyroidism with synthetic levothyroxine. Methods: This cross-sectional study included 160 patients aged 18–70 years and with primary autoimmune hypothyroidism (PAH) for at least 3 months with normal thyroid-stimulating hormone values. Anti-thyroid peroxidase levels, basal cortisol levels, and 60-min postadrenocorticotropic hormone test were done in the 20 patients who continued to be symptomatic on the Zulevski scale despite euthyroid levels. The comparison of various demographic and clinical factors was done with adrenal insufficiency. P <0.05 was considered statistically significant. Results: Among 20 symptomatic AIT patients, 8 (40%) were found to have adrenal insufficiency. There was no statistical difference in the age, gender, body mass index, and duration of disease with adrenal insufficiency (P > 0.05). The mean dose of L-thyroxine with adrenal insufficiency and those without adrenal insufficiency were comparable and the difference was not statistically significant (62.5 vs. 68.75 P = 0.4). Conclusions: Adrenal insufficiency may be present in patients with hypothyroidism who continue to be symptomatic despite euthyroid levels. The investigations in such patients must not be restricted to just thyroid monitoring but must extend to adrenal function assessment to rule out polyglandular involvement.
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spelling doaj-art-94f1bbd16e6b4998865a0a491bb35e342025-08-20T03:09:12ZengWolters Kluwer Medknow PublicationsAPIK Journal of Internal Medicine2666-18022666-18102025-03-0113210611010.4103/ajim.ajim_68_24A Cross-sectional Study of Prevalence of Adrenal Insufficiency in Patients with Primary Autoimmune Hypothyroidism in a Tertiary Hospital, IndiaParamjit Kaur SainiJubbin Jagan JacobNavjot SinghObjectives: This study aimed to assess the prevalence of adrenal insufficiency in patients with primary hypothyroidism who continued to be symptomatic despite adequate biochemical correction of hypothyroidism with synthetic levothyroxine. Methods: This cross-sectional study included 160 patients aged 18–70 years and with primary autoimmune hypothyroidism (PAH) for at least 3 months with normal thyroid-stimulating hormone values. Anti-thyroid peroxidase levels, basal cortisol levels, and 60-min postadrenocorticotropic hormone test were done in the 20 patients who continued to be symptomatic on the Zulevski scale despite euthyroid levels. The comparison of various demographic and clinical factors was done with adrenal insufficiency. P <0.05 was considered statistically significant. Results: Among 20 symptomatic AIT patients, 8 (40%) were found to have adrenal insufficiency. There was no statistical difference in the age, gender, body mass index, and duration of disease with adrenal insufficiency (P > 0.05). The mean dose of L-thyroxine with adrenal insufficiency and those without adrenal insufficiency were comparable and the difference was not statistically significant (62.5 vs. 68.75 P = 0.4). Conclusions: Adrenal insufficiency may be present in patients with hypothyroidism who continue to be symptomatic despite euthyroid levels. The investigations in such patients must not be restricted to just thyroid monitoring but must extend to adrenal function assessment to rule out polyglandular involvement.https://journals.lww.com/10.4103/ajim.ajim_68_24adrenal insufficiencycortisolhypothyroidism
spellingShingle Paramjit Kaur Saini
Jubbin Jagan Jacob
Navjot Singh
A Cross-sectional Study of Prevalence of Adrenal Insufficiency in Patients with Primary Autoimmune Hypothyroidism in a Tertiary Hospital, India
APIK Journal of Internal Medicine
adrenal insufficiency
cortisol
hypothyroidism
title A Cross-sectional Study of Prevalence of Adrenal Insufficiency in Patients with Primary Autoimmune Hypothyroidism in a Tertiary Hospital, India
title_full A Cross-sectional Study of Prevalence of Adrenal Insufficiency in Patients with Primary Autoimmune Hypothyroidism in a Tertiary Hospital, India
title_fullStr A Cross-sectional Study of Prevalence of Adrenal Insufficiency in Patients with Primary Autoimmune Hypothyroidism in a Tertiary Hospital, India
title_full_unstemmed A Cross-sectional Study of Prevalence of Adrenal Insufficiency in Patients with Primary Autoimmune Hypothyroidism in a Tertiary Hospital, India
title_short A Cross-sectional Study of Prevalence of Adrenal Insufficiency in Patients with Primary Autoimmune Hypothyroidism in a Tertiary Hospital, India
title_sort cross sectional study of prevalence of adrenal insufficiency in patients with primary autoimmune hypothyroidism in a tertiary hospital india
topic adrenal insufficiency
cortisol
hypothyroidism
url https://journals.lww.com/10.4103/ajim.ajim_68_24
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