{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:31:55Z","timestamp":1787164315164,"version":"build-2736575974"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The aim of this review was to evaluate the association between anti-thyroid antibodies and quality of life in people with euthyroid Hashimoto thyroiditis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Patients with Hashimoto thyroiditis report symptom distress more often than those with non-autoimmune thyroid disorders. Therefore, anti-thyroid antibodies may be related to decreased quality of life in persons with Hashimoto thyroiditis. The etiology of lingering symptoms, even in euthyroidism, remains unknown. The relationship between anti-thyroid antibodies and quality of life for people with Hashimoto thyroiditis has not been evaluated in a systematic review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Inclusion criteria:<\/jats:title>\n                    <jats:p>The participants were males and females at least 12 years of age, in any country, with Hashimoto thyroiditis. Participants not in a euthyroid state were excluded from this review. In this review, the exposure was the presence of anti-thyroid antibodies and the primary outcome was quality of life as measured by a validated scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A three-step search strategy was implemented with an initial search of PubMed and CINAHL. A comprehensive database search using all identified keywords and index terms was undertaken in March 2019 for relevant published literature, gray literature, and clinical trial registries. The final updates to the search strategies were conducted in December 2019. The search was limited to studies published in English after 1956. Two independent reviewers completed screening for inclusion and utilized the recommended JBI approach to critical appraisal, study selection, data extraction, and data synthesis. The findings are presented in a meta-analysis and in a narrative synthesis, which includes tables and figures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      All 13 studies had high methodological quality. Four studies found a significant correlation (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u200a&lt;\u200a0.05) between the presence of anti-thyroid antibodies and quality of life. A fifth study found a significant correlation (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u200a&lt;\u200a0.001) between higher antibody levels and quality of life. A meta-analysis was conducted using two cross-sectional studies, which revealed that the summative small effect size was statistically significant and suggested a lower quality of life in antibody-positive patients. Due to the heterogeneity of the studies, a narrative synthesis was conducted for the three secondary outcomes: symptom distress, executive function, and mental health. Three studies found a statistically significant (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u200a&lt;\u200a0.05) correlation between symptom distress and antibodies, two studies found a statistically significant (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u200a&lt;\u200a0.05) association between executive function and antibodies, and all but one study found a statistically significant (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u200a&lt;\u200a0.05) relationship between mental health and antibodies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The findings in this review did not reveal a definitive relationship between antibodies and quality of life. However, our meta-analysis suggested a link between anti-thyroid antibodies and decreased quality of life in euthyroid children and adults. Though not conclusive, poor mental health and symptom distress may be associated with anti-thyroid antibodies. Therefore, it may be beneficial to periodically evaluate the quality of life and mental health in euthyroid patients with positive antibodies. It is unlikely that antibodies and executive functions are related. The studies and our review's limitations require replication of findings to confirm a connection between antibodies, quality of life, and the secondary outcomes. Future research should continue to evaluate the relationship between anti-thyroid antibodies and the quality of life in individuals with euthyroid Hashimoto thyroiditis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration number:<\/jats:title>\n                    <jats:p>PROSPERO CRD42018084663<\/jats:p>\n                  <\/jats:sec>","DOI":"10.11124\/jbies-20-00043","type":"journal-article","created":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T20:29:45Z","timestamp":1616185785000},"page":"2307-2338","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":11,"title":["Association between anti-thyroid antibodies and quality of life in patients with Hashimoto thyroiditis: a systematic review and meta-analysis"],"prefix":"10.11124","volume":"19","author":[{"given":"Marion","family":"Patti","sequence":"first","affiliation":[{"name":"School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA"},{"name":"Mississippi Centre of Evidence Based Practice: A JBI Centre of Excellence, Jackson, MS, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Christian","sequence":"additional","affiliation":[{"name":"School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA"},{"name":"Mississippi Centre of Evidence Based Practice: A JBI Centre of Excellence, Jackson, MS, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Palokas","sequence":"additional","affiliation":[{"name":"School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA"},{"name":"Mississippi Centre of Evidence Based Practice: A JBI Centre of Excellence, Jackson, MS, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,9]]},"reference":[{"issue":"(3)","key":"R1-20250613","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1210\/jc.2013-2409","article-title":"The incidence and prevalence of thyroid dysfunction in Europe: a meta-analysis","volume":"99","author":"Garmendia","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"issue":"(10)","key":"R3-20250613","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1089\/thy.2016.0229","article-title":"2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis","volume":"26","author":"Ross","year":"2016","journal-title":"Thyroid"},{"issue":"(1)","key":"R4-20250613","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1023\/B:QURE.0000015315.35184.66","article-title":"Health-related quality of life in patients with thyroid disorders","volume":"13","author":"Bianchi","year":"2004","journal-title":"Qual Life Res"},{"issue":"(2)","key":"R5-20250613","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.autrev.2014.10.016","article-title":"Autoimmune thyroid disorders","volume":"14","author":"Antonelli","year":"2015","journal-title":"Autoimmun Rev"},{"key":"R6-20250613","article-title":"Chapter 16: Disorders of the thyroid gland","author":"Jameson","year":"2015","journal-title":"Harrison's principles of internal medicine"},{"key":"R7-20250613","article-title":"Chapter 9: Diagnostic algorithms","author":"Nicoll","year":"2012","journal-title":"Pocket guide to diagnostic tests"},{"issue":"(6)","key":"R8-20250613","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1016\/j.amjsurg.2013.05.005","article-title":"Quality of life after thyroid surgery in women with benign euthyroid goiter: influencing factors including Hashimoto's thyroiditis","volume":"207","author":"Promberger","year":"2014","journal-title":"Am J Surg"},{"issue":"(4)","key":"R9-20250613","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/j.bbi.2012.01.006","article-title":"Thyroid peroxidase antibody positivity is associated with symptomatic distress in patients with Hashimoto's thyroiditis","volume":"26","author":"Mussig","year":"2012","journal-title":"Brain Behav Immun"},{"issue":"(1)","key":"R10-20250613","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1530\/EJE-14-0147","article-title":"Serum negative autoimmune thyroiditis displays a milder clinical picture compared with classic Hashimoto's thyroiditis","volume":"171","author":"Rotondi","year":"2014","journal-title":"Eur J Endocrinol"},{"issue":"(4)","key":"R11-20250613","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1188\/03.ONF.601-606","article-title":"Symptoms experience: a concept analysis","volume":"30","author":"Armstrong","year":"2003","journal-title":"Oncol Nurs Forum"},{"issue":"(2)","key":"R12-20250613","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1089\/thy.2010.0191","article-title":"Hashimoto's thyroiditis affects symptom load and quality of life unrelated to hypothyroidism: a prospective case-control study in women undergoing thyroidectomy for benign goiter","volume":"21","author":"Ott","year":"2011","journal-title":"Thyroid"},{"issue":"(6)","key":"R13-20250613","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1530\/eje.1.02025","article-title":"Cognitive functioning and well-being in euthyroid patients on thyroxine replacement therapy for primary hypothyroidism","volume":"153","author":"Wekking","year":"2005","journal-title":"Eur J Endocrinol"},{"issue":"(6)","key":"R14-20250613","doi-asserted-by":"crossref","first-page":"e0156925","DOI":"10.1371\/journal.pone.0156925","article-title":"Disease-specific as well as generic quality of life is widely impacted in autoimmune hypothyroidism and improves during the first six months of levothyroxine therapy","volume":"11","author":"Winther","year":"2016","journal-title":"PLoS One"},{"issue":"(8)","key":"R15-20250613","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/j.kjms.2016.06.006","article-title":"Autoimmunity affects health-related quality of life in patients with Hashimoto's thyroiditis","volume":"32","author":"Uysal","year":"2016","journal-title":"Kaohsiung J Med Sci"},{"issue":"(3)","key":"R16-20250613","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1159\/000342623","article-title":"Is thyroid autoimmunity per se a determinant of quality of life in patients with autoimmune hypothyroidism?","volume":"1","author":"Watt","year":"2012","journal-title":"Eur Thyroid J"},{"issue":"(3)","key":"R17-20250613","first-page":"34","article-title":"Symptoms in euthyroid Hashimoto's thyroiditis: is there a role for autoimmunity itself?","volume":"22","author":"Dardano","year":"2012","journal-title":"Thyroid"},{"key":"R18-20250613","doi-asserted-by":"crossref","first-page":"521","DOI":"10.3389\/fimmu.2017.00521","article-title":"Thyroid autoimmunity: role of anti-thyroid antibodies in thyroid and extra-thyroidal diseases","volume":"8","author":"Fr\u00f6hlich","year":"2017","journal-title":"Front Immunol"},{"issue":"(10)","key":"R19-20250613","doi-asserted-by":"crossref","first-page":"1432","DOI":"10.1016\/j.psyneuen.2008.08.009","article-title":"Increased occurrence of weaknesses in attention testing in patients with Hashimoto's thyroiditis compared to patients with other thyroid illnesses","volume":"33","author":"Leyhe","year":"2008","journal-title":"Psychoneuroendocrinology"},{"issue":"(1)","key":"R20-20250613","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.genhosppsych.2013.10.002","article-title":"The prevalence of depression and anxiety disorders in patients with euthyroid Hashimoto's thyroiditis: a comparative study","volume":"36","author":"Giynas Ayhan","year":"2014","journal-title":"Gen Hosp Psychiatry"},{"issue":"(8)","key":"R21-20250613","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1507\/endocrj.EJ12-0035","article-title":"Depression in patients with euthyroid chronic autoimmune thyroiditis","volume":"59","author":"Kirim","year":"2012","journal-title":"Endocr J"},{"issue":"(5)","key":"R22-20250613","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1111\/j.1600-0447.2012.01870.x","article-title":"Association between thyroid function, thyroid autoimmunity, and state and trait factors of depression","volume":"126","author":"van de Ven","year":"2012","journal-title":"Acta Psychiatr Scand"},{"issue":"(9)","key":"R23-20250613","first-page":"3194","article-title":"Are autoimmune thyroid dysfunction and depression related?","volume":"83","author":"Pop","year":"1998","journal-title":"J Clin Endocrinol Metab"},{"issue":"(10)","key":"R24-20250613","doi-asserted-by":"crossref","first-page":"3708","DOI":"10.1210\/jc.2014-1322","article-title":"The thyroid-related quality of life measure ThyPRO has good responsiveness and ability to detect relevant treatment effects","volume":"99","author":"Watt","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"key":"R25-20250613","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.jclinepi.2016.03.006","article-title":"A systematic review of quality of thyroid-specific health-related quality-of-life instruments recommends ThyPRO for patients with benign thyroid diseases","volume":"78","author":"Wong","year":"2016","journal-title":"J Clin Epidemiol"},{"key":"R26-20250613","doi-asserted-by":"crossref","first-page":"185859","DOI":"10.1155\/2015\/185859","article-title":"Treated autoimmune thyroid disease is associated with a decreased quality of life among young persons with type 1 diabetes","volume":"2015","author":"Spirkova","year":"2015","journal-title":"Int J Endocrinol"},{"issue":"(6947)","key":"R27-20250613","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1016\/S0140-6736(56)92249-8","article-title":"Auto- antibodies in Hashimoto's disease: lymphadenoid goiter","volume":"268","author":"Roitt","year":"1956","journal-title":"Lancet"},{"issue":"(11)","key":"R29-20250613","doi-asserted-by":"crossref","first-page":"2604","DOI":"10.11124\/JBISRIR-2016-003315","article-title":"The association between anti-thyroid antibodies and quality of life in patients with thyroid disorders: a systematic review protocol","volume":"15","author":"Patti","year":"2017","journal-title":"JBI Database System Rev Implement Rep"},{"issue":"(3)","key":"R30-20250613","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1097\/XEB.0000000000000065","article-title":"Fixed or random effects meta-analysis? Common methodological issues in systematic reviews of effectiveness","volume":"13","author":"Tufanaru","year":"2015","journal-title":"Int J Evid Based Healthc"},{"issue":"(7)","key":"R31-20250613","doi-asserted-by":"crossref","first-page":"e1000097","DOI":"10.1371\/journal.pmed.1000097","article-title":"The PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement","volume":"6","author":"Moher","year":"2009","journal-title":"PLoS Med"},{"key":"R32-20250613","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/1745-0179-1-23","article-title":"A case control study on psychiatric disorders in Hashimoto disease and Euthyroid Goitre: not only depressive but also anxiety disorders are associated with thyroid autoimmunity","volume":"1","author":"Carta","year":"2005","journal-title":"Clin Pract Epidemiol Ment Health"},{"key":"R33-20250613","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.ijsu.2015.08.001","article-title":"Quality of life improvement in patients with Hashimoto thyroiditis and other goiters after surgery: a prospective cohort study","volume":"21","author":"Zivaljevic","year":"2015","journal-title":"Int J Surg"},{"issue":"(1)","key":"R34-20250613","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1007\/s12020-018-1649-6","article-title":"Cognitive functioning and quality of life in patients with Hashimoto thyroiditis on long-term levothyroxine replacement","volume":"62","author":"Djurovic","year":"2018","journal-title":"Endocrine"},{"key":"R35-20250613","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.psyneuen.2014.01.015","article-title":"Structural and functional MRI study of the brain, cognition and mood in long-term adequately treated Hashimoto's thyroiditis","volume":"42","author":"Quinque","year":"2014","journal-title":"Psychoneuroendocrinology"},{"issue":"(4)","key":"R36-20250613","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1507\/endocrj.EJ16-0418","article-title":"Is thyroid autoimmunity itself associated with psychological well-being in euthyroid Hashimoto's thyroiditis?","volume":"64","author":"Yalcin","year":"2017","journal-title":"Endocr J"},{"issue":"(7414)","key":"R38-20250613","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"BMJ"},{"issue":"(2)","key":"R41-20250613","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1080\/08820139.2018.1529040","article-title":"Thyroglobulin antibodies are associated with symptom burden in patients with Hashimoto's thyroiditis: a cross-sectional study","volume":"48","author":"Bari\u0107","year":"2019","journal-title":"Immunol Invest"},{"key":"R42-20250613","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1016\/j.psyneuen.2009.03.011","article-title":"Increased prevalence of antibodies to central nervous system tissue and gangliosides in Hashimoto's thyroiditis compared to other thyroid illnesses","volume":"34","author":"Mussig","year":"2009","journal-title":"Psychoneuroendocrinology"},{"issue":"(1)","key":"R43-20250613","first-page":"299","article-title":"Hashimoto's thyroiditis induces neuroinflammation and emotional alterations in euthyroid mice","volume":"15","author":"Bromi\u0144ska","year":"2018","journal-title":"J Neuroinflammation"},{"key":"R44-20250613","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1017\/S0033291708004960","article-title":"Neuropsychological functioning, illness perception, mood and quality of life in chronic fatigue syndrome, autoimmune thyroid disease and healthy participants","volume":"39","author":"Dickson","year":"2009","journal-title":"Psychol Med"},{"issue":"(10)","key":"R45-20250613","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1016\/S2213-8587(15)00325-3","article-title":"New insights into the variable effectiveness of levothyroxine monotherapy for hypothyroidism","volume":"3","author":"McAninch","year":"2015","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"(1)","key":"R46-20250613","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/BF03401282","article-title":"Hashimoto's thyroiditis: history and future outlook","volume":"12","author":"Hiromatsu","year":"2013","journal-title":"Hormones"}],"container-title":["JBI Evidence Synthesis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.11124\/JBIES-20-00043","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T12:35:14Z","timestamp":1786451714000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.11124\/JBIES-20-00043"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,17]]},"references-count":41,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.11124\/jbies-20-00043","relation":{},"ISSN":["2689-8381"],"issn-type":[{"value":"2689-8381","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,17]]}}}