A nursing student recently used and TikTok video He went viral for sharing what he believes his Apple Watch can help diagnose thyroid disease. Stating that such wearable devices can track oxygen levels, heart rate, the presence of irregular heartbeats and VO2 max, he explained that he believes that if the notifications were on, they could indicate a problem with his thyroid. He was later diagnosed with hypothyroidism.
Stories of people detecting potential health abnormalities through their consumer wearables are becoming commonplace, as users have wearables that can passively track health information on their wrists, such as the Apple Watch or Fitbit. AND Pew Research Center survey A June 2019 study showed that by that time, 21% of US adults regularly wore a smartwatch or fitness tracker.
These devices use plethysmography to measure heart rate, heart rhythm (normal sinus rhythm versus atrial fibrillation), blood oxygen saturation, and VO2 max (maximum oxygen uptake as a proxy for cardio fitness).
The Right Wearable Devices to Track Heart Rate
Numerous studies proving its accuracy heart rate data from wearable devices Compared to traditional measurement, although there are minor differences between smartwatch brands.
Concerning heart rhythm, a large essay published New England Journal of Medicine, Apple Heart StudyIt recruited 419,297 patients and found an 84% positive predictive value between irregular heart rhythm notifications and a diagnosis of atrial fibrillation on Apple Watch.
One study revealed that wearable device heart rate may correlate well with patients’ thyroid disease status. This study examined 30 hypothyroid patients and 14 euthyroid patients who received radioactive iodine therapy for thyroid cancer. They found that a decrease in Fitbit heart rate by 1 standard deviation was associated with a 0.2 ng/dL decrease in free thyroxine levels and a twofold increase in the hypothyroidism odds ratio. Heart rate measured by wearable devices shown better sensitivity More than the resting heart rate measured in the office environment due to the higher volume and frequency of data collected.
Therefore, we believe that in the near future, doctors will often prescribe a wearable wrist device alongside thyroid function tests to support patients’ management of their thyroid disease.
The Rise in Telemedicine May Require More Use of Wearable Device Data
We also believe that, with the rise in telemedicine triggered by the COVID-19 pandemic and some people opting for remote visits, wearables will further enable a shift in care to rely on data points from wearables to inform our patient care.
We saw this firsthand in Ms B, a recent patient admitted to the hospital with atrial fibrillation with a rapid ventricular response. We diagnosed him with Graves’ disease and discharged him on methimazole.
During her post-discharge telehealth appointment, she described heart rates dropping from her Fitbit to between 40 and 60 bpm. Using this information and thyroid function tests, we had confidence in reducing the methimazole dose remotely.
Since she has only nonspecific symptoms, we used heart rate trends as an objective way to monitor her condition. This allowed Ms. B to make sure Graves’ disease was being treated appropriately.
We have previously published other reports About similar situations where wearable devices that monitor heart rate help in diagnosing and treating thyroid disease.
VO2 Max Needs More Verification
Over the past decade, wearable wrist technology has been widely adopted. Patients with known or undiagnosed thyroid disease are increasingly likely to wear smartwatches, giving them the opportunity to learn more about their health from something already on their wrists. Certain metrics, such as heart rate and rhythm, have been extensively researched and validated, whereas other metrics remain more promising than reality. Over time, other and more measurements and data from these devices could provide greater visibility into pathophysiology than is possible today.
We envision a future where measurements such as VO2 max or energy expenditure from wearable devices can provide more useful information for thyroid disease management.
Wearable technology now enables us to implement better telehealth and leverage continuous heart rate data in conjunction with patients’ reported symptoms to better enable accurate remote assessment of thyroid function.
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