Evidence map›Paper›PMID 41210497›Full record

ArticleFrontiers in endocrinology2025

Sleep quality during preparation for RAI: recombinant TSH vs. levothyroxine withdrawal.

Georgios K Markantes, Konstantinos Dimitropoulos, Anastasia Armeni, Niki Chrysanthopoulou, Konstantinos Georgiou, Irene Mamali, Neoklis A Georgopoulos, Anastasia Theodoropoulou

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Frontiers in endocrinology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Georgios K MarkantesDivision of Endocrinology - Department of Internal Medicine, University of Patras School of Health Sciences, Patras, Greece.
Konstantinos DimitropoulosDivision of Endocrinology - Department of Internal Medicine, University of Patras School of Health Sciences, Patras, Greece.
Anastasia ArmeniDivision of Endocrinology - Department of Internal Medicine, University of Patras School of Health Sciences, Patras, Greece.
Niki ChrysanthopoulouDivision of Endocrinology - Department of Internal Medicine, University of Patras School of Health Sciences, Patras, Greece.
Konstantinos GeorgiouDivision of Endocrinology - Department of Internal Medicine, University of Patras School of Health Sciences, Patras, Greece.
Irene MamaliDivision of Endocrinology - Department of Internal Medicine, University of Patras School of Health Sciences, Patras, Greece.
Neoklis A GeorgopoulosDivision of Endocrinology - Department of Internal Medicine, University of Patras School of Health Sciences, Patras, Greece.
Anastasia TheodoropoulouDivision of Endocrinology - Department of Internal Medicine, University of Patras School of Health Sciences, Patras, Greece.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Patients with differentiated thyroid cancer (DTC) suffer from impaired sleep quality, which may be further impaired after radioactive iodine (RAI) treatment. The potential contribution of the type of preparation for RAI has not been studied. Our objective was to compare the effect of the types of preparation for RAI on the sleep quality of DTC patients, and to correlate sleep indices with hormonal and psychological parameters. Methods: we studied 104 DTC patients (76 women and 28 men) programmed to receive RAI, two to eight months after total thyroidectomy. Participants were classified into two groups, based on the type of preparation: 56 were prepared with levothyroxine withdrawal (LT4-W group) and 48 with recombinant human TSH (rhTSH) administration (rhTSH group). Assessment was done in the morning of RAI administration and included hormonal determinations (thyroid function tests, prolactin, cortisol, and adrenocorticotropic hormone) and evaluation of sleep quality (Pittsburg Sleep Quality Index-PSQI) and anxiety/depression levels (Hospital Anxiety and Depression Scale-HADS). Results: The two study groups did not differ in age and gender distribution, DTC histology, RAI indications and administered dose, thyroglobulin and anti-thyroglobulin antibodies levels. The rhTSH group demonstrated higher TSH and free thyroxine, and lower prolactin and cortisol; participants of this subgroup had better subjective quality (0.65 ± 0.71 vs 1.22 ± 0.92, p=0.002) and efficiency (0.35 ± 0.74 vs 0.72 ± 0.96, p=0.023), less daytime dysfunction (0.52 ± 0.59 vs 0.87 ± 0.82, p=0.03), and better global PSQI score (4.72 ± 3.32 vs 6.60 ± 3.99, p=0.014), while they also showed lower anxiety/depression scores compared to individuals in the LT4-W group (4.32 ± 4.22 vs 5.62 ± 3.85, p=0.046 and 3.55 ± 3.41 vs 5.86 ± 4.22, p=0.005, respectively). The between-groups differences in the above PSQI domains remained after correction for hormonal levels but disappeared (except for that in subjective quality) after correcting for anxiety/depression levels. Conclusions: In DTC patients receiving RAI, preparation with rhTSH could contribute to better sleep quality compared to LT4 withdrawal. Increased depression and anxiety rather than differences in hormone levels seemed to mediate this difference.

Indexed as

Iodine RadioisotopesSleep QualityThyroid NeoplasmsThyrotropinThyroxineAdultFemaleHumansMaleMiddle AgedRecombinant ProteinsThyroidectomyIodine RadioisotopesRecombinant ProteinsThyrotropinThyroxinelevothyroxine withdrawalpreparationradioactive iodinerecombinant human thyrotropin (rhTSH)sleepthyroid cancer

Identifiers

PMID41210497
PMCPMC12591871

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.