Department of Endocrinology, Astghik MC, Yerevan, Armenia · Department of Propaedeutics of Internal Diseases Yerevan State Medical Unevrsity, Head of the Therapy Clinic of the "Mikaelyan " University Hospital, Yerevan, Armenia · Yerevan State Medical University
Background and Objectives: By analyzing the existing research, we find that in case of mild subclinical
hypothyroidism, patients often may not have any complaints, and if they do, the complaints might be related to another coexisting clinical condition. Such complaints may occur in case of existence of hypoadrenia or so-called ''adrenal fatigue syndrome''. The goal of the study is to examine the clinical symptoms and their frequency in patients with subclinical hypothyroidism and borderline changes in adrenal stress response hormones — cortisol and DHEA-S and to compare these symptoms with those observed in patients without hypothyroidism but with functional adrenal deviations.
Materials and methods: The study included 27 patients who visited the Department of Endocrine Surgery at "Astghik"
Medical Center between 2014 and 2022 and were diagnosed with subclinical hypothyroidism and had borderline
deviations in adrenal hormones. The patients were split into three groups based on the deviations in adrenal hormone
levels. Group I included 21 patients with elevated cortisol levels. Group II included 2 patients with increase in both
cortisol and DHEA-S levels. Group III included 4 patients with elevated DHEA-S levels only. A percentage analysis of
clinical symptoms was conducted among the patients and compared to the symptoms reported by patients presenting
with adrenal hormone deviations only.
Results: As a result of the study, the common complaints reported across all groups included: general weakness, anxiety, fatigue, headaches, dizziness, mood decline, palpitations, elevated blood pressure, excessive sweating, muscle tension, shortness of breath, and pigmented spots. When comparing with the complaints of patients presenting solely with hypoadrenia it reveals that the coexistence of subclinical hypothyroidism and hypoadrenia is associated with a higher prevalence of symptoms. In terms of the reproductive system, the two common symptoms observed across the groups were hirsutism and menstrual irregularities.
Conclusions: Thus, we conclude that in patients presenting with complaints and subclinical hypothyroidism, the
underlying cause of the symptoms may be another condition—specifically, coexisting adrenal fatigue. In this context,
the presence of subclinical hypothyroidism may act as an additional stress factor, potentially placing further strain on
adrenal function and making the manifestation of symptoms more noticeable.
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