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

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. 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.