Wechselwirkung von Ernährung, Hormonsystem und körperliche Aktivität auf die Skelettmuskeladaptation: Fokus Schilddrüse

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Abstract

About 3 - 8 % of the European population suffer from hypothyroidism. A difference can be made between the two forms: overt and subclinical hypothyroidism (sHT). The symptoms of the disease range from uncontrolled weight gain, muscle pain, cold intolerance, and lack of motivation to constipation, bradycardia, and depression. In addition, hypothyroidism is associated with reduced quality of life (QoL) and increased mortality. Overt hypothyroidism, as well as sHT with TSH levels above 10.0 mU/l, is conventionally treated with levothyroxine (L-T4). Whether a sHT with TSH values between 5 and 9 mU/l is treated with L-T4 is individually dependent on the patient's clinical situation, such as age, complaints, and cardiovascular risk factors. However, the majority of patients, despite treatment with L-T4, report existing symptoms and reduced QoL. In addition, patients with hypothyroidism show significant performance limitations during exercise. For this reason, there is a need for the development of a complementary or an alternative therapeutic treatment.
Taking into account the problem of an often unsatisfying therapy of hypothyroidism, approaches for alternative or complementary treatments will be developed for the first time in this dissertation. Interventions in the field of nutrition and sports therapy seem to be promising approaches. Within the framework of four publications, the influence of dietary modifications and physical activity on thyroid function is investigated on the one hand, and on the other hand, the extent to which L-T4 can influence physical performance and health- related QoL.
It has been shown that exercise or diet interventions have the potential to improve patients' QoL. For example, caloric restriction or alternate day fasting have not been shown to alter thyroid function but have been shown to improve hypothyroidism-specific adverse associated symptoms. However, the research gap regarding diet-specific interventions is large. At this time, only trends but no clear recommendations for action can be derived. Likewise, an endurance training intervention may positively influence QoL as well as the development of negative concomitant symptoms of hypothyroidism (e.g., obesity or an unfavorable lipid profile) in sHT patients. There was evidence that an endurance training intervention could help to increase metabolic activity even at lower thyroid hormone concentrations (compared to the time before the intervention). However, the clinical relevance of the effect needs to be verified in future research projects. Furthermore, L-T4 treatment represents a suitable strategy to compensate for performance limitations, especially in strength and endurance, in patients suffering from sHT. However, whether a "healthy" performance level can be achieved by L-T4 treatment is still unclear. Which measures help to further increase the QoL of patients - to a “healthy” level - should be the subject of future research. The investigations carried out in the context of this dissertation provide valuable starting points.
Original languageGerman
Place of PublicationKöln
PublisherDeutsche Sporthochschule Köln
Number of pages65
Publication statusPublished - 2023

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