Musculoskeletal changes in hypothyroidism

Overview

Primary hypothyroidism has a significant impact on disorders of all organ systems, including the muscular system and body composition. The aim of this article is to describe main pathoanatomical and pathophysiological changes in the muscular system of patients with primary hypothyroidism and differences in body composition between hypothyroid and euthyroid population. Thyroid hormone deficiency symptoms are termed as hypothyroid myopathy. The emergence of these symptoms can be often caused by insuficient monitoring or lack of treatment of patients with hypothyroidisim. Myoedema can be a common manifestation, but it is often forgotten in clinical practice. On the other hand, generalized muscular pseudohypertrophy, referred to as Hoffmann‘s syndrome in adults
and Kocher-Debre-Semelaigne syndrome in children is rare. In hypothyroidism, there is also a significant loss of muscle mass and strength, however, with good management we can achieve almost complete remission of sarcopenia. In general, it has been shown that with the increased level of the TSH hormone in hypothyroid patients, the amount of fat in the body also increases. Moreover, the amount of fat-free mass decreases, along with muscle strength. Consequently, patients with hypothyroidism have higher body fat compared to the euthyroid population. Thyroid hormones are also involved in bone development and maturation, affect calcium metabolism and, together with GH and PTH, can contribute to significant changes in bone turnover.

Keywords:

hypothyroid myopathy – myoedema – primary hypothyroidism – sarcopenia – skeletal changes