Respiratory Muscle Strength in Hypothyroidism

doi:10.1378/chest.102.1.189

Chest

Volume 102, Issue 1, July 1992, Pages 189-194

https://doi.org/10.1378/chest.102.1.189 Get rights and content

To investigate respiratory muscle strength in patients with hypothyroidism, global respiratory muscle strength was assessed by measuring mouth pressure during PImax and PEmax efforts. Maximum pressures, VC, FEV₁, FVC, T₃, T₄, and TSH were measured in 43 hypothyroid patients. Measurements were made before amd three months after replacement therapy with thyroxine. The results showed that the mean value of Pimax and PEmax increased after treatment. Significant change was found in the mean value of VC, FEV₁, and FVC after treatment but not in the FEV₁/FVC ratio. A highly statistically significant linear relationship was found between PImax and TSH and between PEmax and TSH as well as between Pimax and T₃ and PEmax and T₃. We conclude that hypothyroidism affects respiratory muscle strength and that this weakness is linearly related to thyroid hormone levels. Respiratory muscle weakness is present in both inspiratory and expiratory muscles and is reversible with treatment.

(Chest 1992; 102:189–194)

Section snippets

Clinical Data

We studied 43 hypothyroid patients, 15 with idiopathic (primary) and 28 with iatrogenic myxedema. All patients were ambulatory and were recruited from the Endocrinology Department in a consecutive order. Patients with iatrogenic myxedema had had a thyroidectomy for papillary thyroid carcinoma at least one year before this study. Four weeks before measurements, replacement (thyroxine) therapy had been stopped in order for the patients to be investigated for metastatic disease. Anthropometric

RESULTS

The mean value of PImax (± 1 SD) for all 43 patients was 83 ± 25 cm H₂O before and 117 ± 98 cm H₂O after three months of replacement treatment with thyroxine. This change was statistically significant (p<0.0001). The mean value of PEmax (± 1 SD) was 79 ± 31 before and 115 ± 32 after treatment and this difference in the mean values was statistically significant (p<0.0001). The mean values of PImax and PEmax ± 1 SD of the two groups and of the total number of patients are shown as histograms in

DISCUSSION

Respiratory muscle strength was assessed by measurements of maximum inspiratory and expiratory static mouth pressures in 15 patients with primary and 28 with iatrogenic myxedema. The results of this study showed that global respiratory muscle strength was reduced in ambulatory hypothyroid patients. Both PImax and PEmax increased significantly statistically after three months of replacement therapy with thyroxine. These results are in agreement with previous reports that showed respiratory

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Preliminary results of this study were presented at the 22nd Annual Meeting of SEPCR in Antwerp, Belgium, in 1987. This article was presented at the Annual Meeting, American Thoracic Society, 1991, Anaheim, Calif.

Manuscript received June 13; revision accepted October 2.

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Chest

Respiratory Muscle Strength in Hypothyroidism

Section snippets

Clinical Data

RESULTS

DISCUSSION

Chest

Br J Dis Chest

Med Clin North Am

Hypothyroidism: clinical features and complications

J Clin Endocrinol Metab

Disordered breathing during sleep in hypothyroidism

Am Rev Respir Dis

Obstructive sleep apnea in hypothyroidism

N Engl J Med

Ventilatory control in myxedema and hypothyroidism

N Engl J Med

Lung volumes and distensibility, and maximum respiratory pressures in thyroid disease before and after treatment

Thorax

Respiratory muscle force in patients with hypothyroidism [abstract]

Am Rev Respir Dis

Hypothyroidism presenting with respiratory muscle weakness

Am Rev Respir Dis