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

Frontiers in Physiology

Charlotte Markert¹  Mattes Kappert¹  Johanna M. Doerr¹  Susanne Fischer²  Nadine Skoluda³  Urs M. Nater³  Jana Strahler⁴ 

[1] Clinical Biopsychology, Department of Psychology, University of Marburg, Marburg, Germany;Clinical Psychology and Psychotherapy, Institute of Psychology, University of Zurich, Zurich, Switzerland;Clinical Psychology, Department of Psychology, University of Vienna, Vienna, Austria;Department of Psychotherapy and Systems Neuroscience, Faculty of Psychology and Sport Science, Justus Liebig University Giessen, Giessen, Germany;

关键词: early life adversity;    fatigue;    fibromyalgia;    functional somatic syndromes;    hypothalamic-pituitary-thyroid axis;    irritable bowel syndrome;   

DOI  :  10.3389/fphys.2018.00564

来源: DOAJ

【 摘 要 】

Objective: 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.Methods:N = 33 female patients with FSS and n = 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).Results: Patients with FSS did not differ from controls in any thyroid parameters (all p > 0.672). However, the lower the patients’ TSH and the higher their fT4, the greater was their general (β = -0.32, p = 0.064; β = 0.35, p = 0.038) and physical (β = -0.47, p = 0.007; β = 0.32, p = 0.077) fatigue. In addition, emotional neglect (β = -0.32, p = 0.057), physical neglect (β = -0.60, p = 0.001), physical abuse (β = -0.47, p = 0.015), and sexual abuse (β = -0.40, p = 0.026) were linked with lower TSH.Conclusion: 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.

【 授权许可】

Unknown