Severity of thyrotoxicosis is a risk factor for excessive weight gain in treated hyperthyroidism

Objective: Hyperthyroidism is characterized by weight fluctuations and overshoot of weight regain following treatment. We aimed to identify parameters predicting peak percentage weight gain (PWG) in the post-treatment period. Methods: We included 110 patients (73 (66.4%) women) with hyperthyroidism...

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Main Authors: Angelos Kyriacou, Paraskevi Vryza, Alexis Kyriacou, Michalis Picolos, Demetris Lamnisos, Economides Panayiotis, Akheel A Syed
Format: Article
Language:English
Published: Bioscientifica 2025-05-01
Series:European Thyroid Journal
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Online Access:https://etj.bioscientifica.com/view/journals/etj/14/3/ETJ-24-0373.xml
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author Angelos Kyriacou
Paraskevi Vryza
Alexis Kyriacou
Michalis Picolos
Demetris Lamnisos
Economides Panayiotis
Akheel A Syed
author_facet Angelos Kyriacou
Paraskevi Vryza
Alexis Kyriacou
Michalis Picolos
Demetris Lamnisos
Economides Panayiotis
Akheel A Syed
author_sort Angelos Kyriacou
collection DOAJ
description Objective: Hyperthyroidism is characterized by weight fluctuations and overshoot of weight regain following treatment. We aimed to identify parameters predicting peak percentage weight gain (PWG) in the post-treatment period. Methods: We included 110 patients (73 (66.4%) women) with hyperthyroidism 6–36 months after treatment initiation. The primary outcome was PWG of ≥10% (group A) or <10% (group B). We performed adjusted analyses by logistic regression with age, sex, disease-related weight loss, hypothyroidism occurrence, free T4 at diagnosis (fT4-t0) and disease duration as independent variables. Results: Post-treatment mean (SD) weight gain was 7.4 (5.22) kg, whereas disease-related weight loss was 5.3 (5.15) kg. Group A (52.7% participants) compared to group B had significantly higher median (IQR) fT4-t0 at 47.4 (36.2, 97.2) vs 29.3 (22.8, 40.4) ng/dL (P < 0.001) and disease-related weight loss at 6.8 (3, 10) vs 2.5 (0, 4.8) kg (P < 0.001) and non-significantly higher presentation free triiodothyronine at 19.6 (10.4, 44.1) vs 11.8 (8.7, 22.9) pg/mL (P = 0.078) and TRAb at 6.3 (3, 16.1) vs 4.2 (2.4, 8.7) IU/L (P = 0.093), respectively. Significant predictor variables of post-treatment PWG in logistic regression were disease-related weight loss (OR = 1.23, P = 0.002) and fT4-t0 (OR = 1.04, P = 0.008). Conclusion: More than half the patients with hyperthyroidism had ≥10% PWG post-treatment. Indicators of disease severity, namely disease-related weight loss and baseline thyroid hormones, were predictive of excessive weight gain post-treatment and could be utilized for risk stratification and early intervention.
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series European Thyroid Journal
spelling doaj-art-e0cdafc5a8b34e38889c730808bf28fa2025-08-20T02:58:46ZengBioscientificaEuropean Thyroid Journal2235-08022025-05-0114310.1530/ETJ-24-03731Severity of thyrotoxicosis is a risk factor for excessive weight gain in treated hyperthyroidismAngelos Kyriacou0Paraskevi Vryza1Alexis Kyriacou2Michalis Picolos3Demetris Lamnisos4Economides Panayiotis5Akheel A Syed6School of Medicine, European University Cyprus, Nicosia, CyprusSchool of Medicine, European University Cyprus, Nicosia, CyprusCEDM Centre of Endocrinology, Diabetes & Metabolism, Limassol, CyprusAlithias Endocrinology Center, Nicosia, CyprusDepartment of Health Sciences, European University Cyprus, Nicosia, CyprusSchool of Medicine, European University Cyprus, Nicosia, CyprusDiabetes, Endocrinology & Obesity Medicine, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford, UKObjective: Hyperthyroidism is characterized by weight fluctuations and overshoot of weight regain following treatment. We aimed to identify parameters predicting peak percentage weight gain (PWG) in the post-treatment period. Methods: We included 110 patients (73 (66.4%) women) with hyperthyroidism 6–36 months after treatment initiation. The primary outcome was PWG of ≥10% (group A) or <10% (group B). We performed adjusted analyses by logistic regression with age, sex, disease-related weight loss, hypothyroidism occurrence, free T4 at diagnosis (fT4-t0) and disease duration as independent variables. Results: Post-treatment mean (SD) weight gain was 7.4 (5.22) kg, whereas disease-related weight loss was 5.3 (5.15) kg. Group A (52.7% participants) compared to group B had significantly higher median (IQR) fT4-t0 at 47.4 (36.2, 97.2) vs 29.3 (22.8, 40.4) ng/dL (P < 0.001) and disease-related weight loss at 6.8 (3, 10) vs 2.5 (0, 4.8) kg (P < 0.001) and non-significantly higher presentation free triiodothyronine at 19.6 (10.4, 44.1) vs 11.8 (8.7, 22.9) pg/mL (P = 0.078) and TRAb at 6.3 (3, 16.1) vs 4.2 (2.4, 8.7) IU/L (P = 0.093), respectively. Significant predictor variables of post-treatment PWG in logistic regression were disease-related weight loss (OR = 1.23, P = 0.002) and fT4-t0 (OR = 1.04, P = 0.008). Conclusion: More than half the patients with hyperthyroidism had ≥10% PWG post-treatment. Indicators of disease severity, namely disease-related weight loss and baseline thyroid hormones, were predictive of excessive weight gain post-treatment and could be utilized for risk stratification and early intervention.https://etj.bioscientifica.com/view/journals/etj/14/3/ETJ-24-0373.xmlhyperthyroidismthyroidgraves’ diseasethyrotoxicosisweightobesity
spellingShingle Angelos Kyriacou
Paraskevi Vryza
Alexis Kyriacou
Michalis Picolos
Demetris Lamnisos
Economides Panayiotis
Akheel A Syed
Severity of thyrotoxicosis is a risk factor for excessive weight gain in treated hyperthyroidism
European Thyroid Journal
hyperthyroidism
thyroid
graves’ disease
thyrotoxicosis
weight
obesity
title Severity of thyrotoxicosis is a risk factor for excessive weight gain in treated hyperthyroidism
title_full Severity of thyrotoxicosis is a risk factor for excessive weight gain in treated hyperthyroidism
title_fullStr Severity of thyrotoxicosis is a risk factor for excessive weight gain in treated hyperthyroidism
title_full_unstemmed Severity of thyrotoxicosis is a risk factor for excessive weight gain in treated hyperthyroidism
title_short Severity of thyrotoxicosis is a risk factor for excessive weight gain in treated hyperthyroidism
title_sort severity of thyrotoxicosis is a risk factor for excessive weight gain in treated hyperthyroidism
topic hyperthyroidism
thyroid
graves’ disease
thyrotoxicosis
weight
obesity
url https://etj.bioscientifica.com/view/journals/etj/14/3/ETJ-24-0373.xml
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