Journal of Endocrinological Investigation

, Volume 40, Issue 10, pp 1099–1106 | Cite as

Physical performance in newly diagnosed hypothyroidism: a pilot study

  • D. Gallo
  • E. PiantanidaEmail author
  • G. Veronesi
  • A. Lai
  • L. Sassi
  • V. Lombardi
  • E. Masiello
  • P. Premoli
  • E. Bianconi
  • C. Cusini
  • S. Rosetti
  • M. L. Tanda
  • A. Toniolo
  • M. Ferrario
  • L. BartalenaEmail author
Original Article



Hypothyroidism is complicated by neuromuscular symptoms (myalgias, slowness of movements, and tiredness) and signs (easy fatigability and cramps), which may have a negative impact on general well-being and quality of life. In a pilot, prospective, controlled study, we investigated the features of muscle dysfunction in hypothyroidism by disease questionnaire, biochemical measures, and physical performance tests.

Materials and Methods

Fifty-seven consecutive patients with newly diagnosed hypothyroidism were enrolled, 27 subclinical (S-Hypo) and 30 overt (O-Hypo). A series of 30 euthyroid subjects, with similar demographic characteristics, served as controls. Patients were administered a short disease questionnaire and underwent laboratory exams and standardized physical tests, both at baseline and after restoration of biochemical euthyroidism.


Compared to euthyroid controls, the O-Hypo group showed significantly higher prevalence of neuromuscular symptoms and significantly higher serum creatine phosphokinase (CPK) levels (p value < 0.0001). S-Hypo had slightly higher CPK levels and prevalence of neuromuscular symptoms than controls. Both S-Hypo and O-Hypo patients performed worse than controls in the six-minute walking test. Differences between patients and controls in handgrip strength test and timed chair standing test failed to reach statistical significance (although a trend was noticeable), possibly due to the small sample size. In O-Hypo, an inverse correlation was found between CPK levels and the handgrip strength test (p value < 0.001). Restoration of euthyroidism was associated with normalization of questionnaire responses, six-minute walking test, as well as serum CPK levels.


In addition to neuromuscular symptoms, hypothyroidism is associated with abnormalities of physical performance. The six-minute walking test is the most valuable test to assess this aspect. In the pilot study, levothyroxine therapy could reverse muscle functional abnormalities.


Physical performance Hypothyroidism Physical tests Handgrip strength test Six-minute walking test Timed chair standing test 



Daniela Gallo is supported by a University of Insubria Ph.D. scholarship. The statistical analysis was performed by Giovanni Veronesi.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Italian Society of Endocrinology (SIE) 2017

Authors and Affiliations

  • D. Gallo
    • 1
  • E. Piantanida
    • 1
    Email author
  • G. Veronesi
    • 1
    • 3
  • A. Lai
    • 1
  • L. Sassi
    • 1
  • V. Lombardi
    • 1
  • E. Masiello
    • 1
  • P. Premoli
    • 1
  • E. Bianconi
    • 1
  • C. Cusini
    • 1
  • S. Rosetti
    • 1
  • M. L. Tanda
    • 1
  • A. Toniolo
    • 2
  • M. Ferrario
    • 1
  • L. Bartalena
    • 1
    Email author
  1. 1.Endocrine Unit, Department of Medicine and SurgeryUniversity of InsubriaVareseItaly
  2. 2.Department of Biotechnology and Life ScienceUniversity of InsubriaVareseItaly
  3. 3.Research Center in Epidemiology and Preventive Medicine (EPIMED)University of InsubriaVareseItaly

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