Hand Grip Strength in Patients Receiving Hormonal Therapy Post Thyroidectomy: Cross-Sectional Study

Background:？Total thyroidectomy is a common surgical procedure necessitating lifelong levothyroxine replacement therapy to maintain metabolic homeostasis; however, thyroid hormone imbalances profoundly affect skeletal muscle function. Objective: To assess hand grip strength among post-thyroidectomy patients on hormonal therapy. Patients and methods:？A cross-sectional observational study was conducted in an outpatient clinical setting. Participants included 165 adults (aged 25–45 years) who were at least 4 years post-total thyroidectomy. The primary exposures analyzed were the duration since surgery and the current daily levothyroxine dose. The primary outcome was dominant-hand hand grip strength (HGS), measured using a Jamar hydraulic dynamometer, while upper-limb function was assessed using the Jebsen-Taylor Hand Function Test (JTHFT). Results:？The mean dominant-hand HGS was 26.35 ± 2.40 kg. Significant inter-group differences were observed based on surgical duration (p < 0.001), with HGS progressively declining in cohorts with longer postoperative durations. HGS demonstrated a strong inverse correlation with levothyroxine dose (ρ = ？0.658) and age (ρ = ？0.670). In multiple regression modeling, levothyroxine dose emerged as the strongest independent predictor of reduced grip strength (β = ？0.634). Furthermore, HGS exhibited significant inverse correlations with JTHFT subtest completion times, specifically feeding (ρ = ？0.471) and writing (ρ = ？0.414). Conclusion:？Long-term levothyroxine therapy post-thyroidectomy is associated with modest but significant reductions in hand grip strength, especially with higher doses and longer duration. Routine HGS monitoring may identify functional deficits not captured by biochemical tests alone. ？