Prevalence and severity of fatigue in treated hypothyroidism: results of a UK survey

Eur Thyroid J. 2025 May 14;14(3):e250044. doi: 10.1530/ETJ-25-0044. Print 2025 Jun 1.

Abstract

Background: A substantial proportion of patients taking thyroid hormone replacement for hypothyroidism show persistent symptoms. We sought to explore the prevalence and degree of fatigue in this patient group.

Methods: An online survey including the FACIT-F fatigue scale was distributed by two UK patient support organisations, the British Thyroid Foundation (BTF) and The Thyroid Trust (TTT). Overall, 1,334 responses were received, of which 1,251 were complete, unique and from patients with primary hypothyroidism/Hashimoto thyroiditis who reported taking thyroid hormone replacements.

Results: Ninety eight percent of respondents were women and the mean duration of treatment was 10.8 years (SD: 9.74). The mean fatigue score on the FACIT-F scale was 20.5 (SD: 10.5), with 89% of respondents fulfilling criteria for abnormal fatigue. Fatigue scores were not significantly different between respondents of different ages, gender, treatment type or treatment duration. FACIT-F scores were positively correlated with self-declared overall health state (Pearson r = 0.576, P < 0.001).

Conclusions: Fatigue in treated hypothyroidism is very common, and the FACIT-F scores reported are comparable or worse than those recorded for many other chronic conditions. This study suggests that addressing fatigue in this patient group will be key to improving wellbeing and quality of life.

Keywords: FACIT-F; Hashimoto thyroiditis; fatigue; hypothyroidism; levothyroxine; quality of life; tri-iodothyronine.

MeSH terms

  • Adult
  • Aged
  • Fatigue* / epidemiology
  • Fatigue* / etiology
  • Female
  • Hormone Replacement Therapy / adverse effects
  • Humans
  • Hypothyroidism* / complications
  • Hypothyroidism* / drug therapy
  • Hypothyroidism* / epidemiology
  • Male
  • Middle Aged
  • Prevalence
  • Quality of Life
  • Severity of Illness Index
  • Surveys and Questionnaires
  • United Kingdom / epidemiology
  • Young Adult