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Abstract

Background: Hypothyroidism is an endocrine disorder characterized by reduced thyroid hormone production. Beyond its systemic effects, it can involve the peripheral nervous system. This can be assessed through electrodiagnostic testing and by measuring serum neurofilament light chain (NfL), a marker of neuronal damage.

Objectives: The present study aimed to evaluate peripheral neuropathy in patients with hypothyroidism and to examine its relationship with serum NfL concentrations.

Materials and Methods: A case–control study was carried out at Ghazi Al-Hariri Hospital, Baghdad, between September 2024 and May 2025. It included 40 patients with hypothyroidism and 40 healthy controls. All subjects underwent sensory and motor nerve conduction testing. Serum NfL levels were analyzed in a randomly selected subgroup of 20 patients and 20 controls using an ELISA assay, depending on kit availability.

Results: Patients with hypothyroidism demonstrated significantly higher serum NfL levels (26.49 ± 8.18 pg/mL) compared with controls (9.60 ± 1.64 pg/mL; p < 0.001). Nerve conduction studies showed delayed latencies and reduced conduction velocities, most notably in the median and sural nerves (p < 0.001).

Conclusions: These findings indicate that hypothyroidism is associated with peripheral neuropathy and elevated serum NfL levels. NfL holds promise as a simple, non-invasive biomarker for neurological complications in hypothyroidism.

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