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Thyroid Functioning and Fatigue in Women With Functional Somatic Syndromes - Role of Early Life Adversity


Fischer, Susanne; Markert, Charlotte; Strahler, Jana; Doerr, Johanna M; Skoluda, Nadine; Kappert, Mattes; Nater, Urs M (2018). Thyroid Functioning and Fatigue in Women With Functional Somatic Syndromes - Role of Early Life Adversity. Frontiers in Physiology, 9:564.

Abstract

Fatigue is a core feature of functional somatic syndromes (FSS). Fatigue is also prominent in patients with thyroid diseases, which is unsurprising given the role of the hypothalamic-pituitary-thyroid (HPT) axis in regulating physiological energy demands. Research in healthy women has shown that early life adversity is linked with alterations in the HPT axis. In view of the substantial prevalence of early life adversity in patients with FSS, our aim was to investigate whether HPT functioning is related to (a) fatigue, and (b) early life adversity in these patients. = 33 female patients with FSS and = 30 age-matched controls were recruited. Fasting morning blood samples were taken to determine thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), and thyroxine (fT4). General, physical, and mental fatigue were measured via the multidimensional fatigue inventory (MFI). Early life adversity was measured using the childhood trauma questionnaire (CTQ). Patients with FSS did not differ from controls in any thyroid parameters (all > 0.672). However, the lower the patients' TSH and the higher their fT4, the greater was their general (β = -0.32, = 0.064; β = 0.35, = 0.038) and physical (β = -0.47, = 0.007; β = 0.32, = 0.077) fatigue. In addition, emotional neglect (β = -0.32, = 0.057), physical neglect (β = -0.60, = 0.001), physical abuse (β = -0.47, = 0.015), and sexual abuse (β = -0.40, = 0.026) were linked with lower TSH. The lower TSH and the higher fT4, the more fatigue was reported by patients with FSS. In addition, lower TSH was linked with more early life adversity. Larger, prospective studies are warranted to determine whether HPT functioning may be a mediating pathway between early life adversity and fatigue in FSS.

Abstract

Fatigue is a core feature of functional somatic syndromes (FSS). Fatigue is also prominent in patients with thyroid diseases, which is unsurprising given the role of the hypothalamic-pituitary-thyroid (HPT) axis in regulating physiological energy demands. Research in healthy women has shown that early life adversity is linked with alterations in the HPT axis. In view of the substantial prevalence of early life adversity in patients with FSS, our aim was to investigate whether HPT functioning is related to (a) fatigue, and (b) early life adversity in these patients. = 33 female patients with FSS and = 30 age-matched controls were recruited. Fasting morning blood samples were taken to determine thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), and thyroxine (fT4). General, physical, and mental fatigue were measured via the multidimensional fatigue inventory (MFI). Early life adversity was measured using the childhood trauma questionnaire (CTQ). Patients with FSS did not differ from controls in any thyroid parameters (all > 0.672). However, the lower the patients' TSH and the higher their fT4, the greater was their general (β = -0.32, = 0.064; β = 0.35, = 0.038) and physical (β = -0.47, = 0.007; β = 0.32, = 0.077) fatigue. In addition, emotional neglect (β = -0.32, = 0.057), physical neglect (β = -0.60, = 0.001), physical abuse (β = -0.47, = 0.015), and sexual abuse (β = -0.40, = 0.026) were linked with lower TSH. The lower TSH and the higher fT4, the more fatigue was reported by patients with FSS. In addition, lower TSH was linked with more early life adversity. Larger, prospective studies are warranted to determine whether HPT functioning may be a mediating pathway between early life adversity and fatigue in FSS.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:06 Faculty of Arts > Institute of Psychology
Dewey Decimal Classification:150 Psychology
Language:English
Date:2018
Deposited On:22 Nov 2018 12:02
Last Modified:24 Sep 2019 23:54
Publisher:Frontiers Research Foundation
ISSN:1664-042X
OA Status:Gold
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.3389/fphys.2018.00564
PubMed ID:29875680
Project Information:
  • : FunderSNSF
  • : Grant ID105314_129764
  • : Project Titlea psychobiological approach
  • : FunderVolkswagen Foundation
  • : Grant IDII/84905
  • : Project Title

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