Hyperthyroidism sounds urinary problem alarm

Physicians should be alert to urinary problems in women with hyperthyroidism, say researchers who found an association between the endocrine disorder and bladder pain syndrome/interstitial cystitis (BPS/IC).

Herng-Ching Lin (Taipei Medical University, Taiwan) studied data on 736 women who had received a first-time diagnosis of BPS/IC between 2001 and 2011, and 2208 control women matched for age, income, location, and index year.

BPS/IC patients were significantly more likely to have received a prior diagnosis of hyperthyroidism, at 3.3% versus 1.5% among controls, which equated to a 2.01-fold increased odds, after adjusting for comorbidities.

However, when the authors stratified their results by age they found that this relationship was not statistically significant in women under the age of 40 years. Meanwhile, women with BPS/IC aged 40 to 59 years, and those older than 60 years had respective 2.41- and 2.59-fold greater odds for hyperthyroidism than controls.

“[T]he specific mechanisms which underlie this relationship are still unknown,” say Lin and colleagues, who suggest that it may be related to a shared risk for psychologic symptoms such as anxiety, or due to imbalance in the autonomic nervous system, which has also been reported in both BPS/IC and hyperthyroidism. More directly, they speculate that changes in fluid excretion may lead to increased urinary frequency in hyperthyroidism.

“We suggest that clinicians treating female subjects with hyperthyroidism be alert to urinary complaints in this population,” the authors write.

However, they add: “Further study is needed to confirm our findings and explore the underlying pathomechanisms.”

The team also reports in PLoS One that patients with BPS/IC had a significantly higher prevalence of a number of comorbidities than controls, including coronary heart disease (15.6 vs 11.5%), hyperlipidemia (21.7 vs 18.3%), chronic pelvic pain (32.9 vs 17.9%), irritable bowel syndrome (12.6 vs 5.4%), fibromyalgia (34.8 vs 23.8%), depression (12.1 vs 6.5%), migraines (7.6 vs 3.8%), sicca syndrome (2.2 vs 1.0%), allergies (3.5 vs 1.5%), and asthma (10.7 vs 6.8%).

They note that after controlling for such comorbidities, the relationship between hyperthyroidism and BPS/IC remained significant.

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