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Abstract

Background: Hypothyroidism arises from reduced thyroid hormone production or activity due to dysfunction of the hypothalamic-pituitary-thyroid axis. Peripheral polyneuropathy is caused by axonal or myelin sheath damage. This study aimed to explore the neurophysiological impact of hypothyroidism, not to test an intervention.Methods: A cross-sectional observational study was conducted from March to December 2024, involving 50 female hypothyroid patients aged 20–75 years. Patients were divided into controlled (n = 14) and uncontrolled (n = 36) groups. All underwent motor and sensory nerve conduction studies (NCS), F-wave analysis, sural-radial amplitude ratio (SRAR), and needle EMG. Peripheral neuropathy was diagnosed based on reduced SNAP and/or CMAP amplitudes in a length-dependent pattern, while CTS was identified using standard diagnostic criteria including prolonged distal motor latency and reduced median SNAP amplitude.Results: While age and etiology of hypothyroidism were similar between groups, disease duration was significantly shorter in uncontrolled patients (p = 0.007). 22 patients had peripheral neuropathy, 14 had carpal tunnel syndrome, and 14 had normal neurophysiological findings. Uncontrolled patients showed significantly reduced SNAP and CMAP amplitudes across multiple nerves (p < 0.05) and lower SRAR (p < 0.001). In the uncontrolled group, TSH was inversely associated with sural SCV (r = –0.480; p = 0.004) and positively with median DML (r = 0.364; p = 0.032).Conclusion: Despite shorter disease duration, uncontrolled hypothyroid patients showed more peripheral nerve issues possibly indicating subclinical disease. Better metabolic control improves neurophysiological outcomes. Regular thyroid hormone and nerve tests are vital for early detection and prevention. Proper hormonal management is key for metabolic health and nerve integrity.

DOI

10.52573/ipmj.2025.162851

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