Beyond Hormones: thyroid disorders and the hidden burden on quality of life in Southern Saudi Arabia

Abstract

Objective: This study aimed to assess the health-related quality of life (HRQoL) among adults with thyroid disorders in southern Saudi Arabia and identified modifiable lifestyle factors asso-ciated with better outcomes. Methods: A cross-sectional survey of 1,250 Saudi adults (≥18 years) was conducted in May 2024. Participants completed validated instruments assessing sociodemographic characteristics, physician-diagnosed thyroid conditions (hypothyroidism, hyperthyroidism, thyroid nodules, thyroid cancer), anthropometric measurements, lifestyle behaviors, and HRQoL using the Arabic WHO Quality of Life-BREF (WHOQOL-BREF). Results: Of 1,250 participants (mean age 34 ± 13 years; 44% female), 120 (9.6%) reported diagnosed thyroid disorders. Compared to unaffected individuals, those with thyroid conditions demonstrated significantly lower mean QoL scores across all domains, with the largest def-icit in social relationships (54.6 ± 23.1 vs. 67.8 ± 21.7, p < 0.001). After multivariable ad-justment, hyperthyroidism remained independently associated with reduced psychological health (β ≤ âˆ'8.14, 95% CI: âˆ'15.72 to âˆ'0.56, p ≤ 0.035), while any thyroid disorder predicted poorer social functioning (β ≤ âˆ'13.15, 95% CI: âˆ'25.23 to âˆ'1.07, p ≤ 0.033). Among lifestyle factors, regular physical activity showed the strongest positive associations with all QoL domains (β ≤ 4.02 to 5.47, all p < 0.001), whereas elevated BMI demonstrated consistent negative associations, particularly with psychological well-being (β ≤ âˆ'0.31, p < 0.001). Conclusion: Thyroid disorders substantially impair patient-reported quality of life, with psychological and social domains most affected. The strong associations between physical activity and superior QoL across all domains suggested potential therapeutic targets beyond traditional pharmacological management.