Physiologic Effects of Levothyroxine and Liothyronine in the in Older Individuals With Persistent Subclinical Hypothyroidism: A Randomized, Double-Blind, Cross-Over Study Article Swipe
Paige Meizlik
,
Andrew J. Cucchiara
,
Lakshmi Kannan
,
Jarvis C. Mays
,
Jennifer F. Jolivert
,
Theresa Scattergood
,
Anne Rentoumis Cappola
·
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1210/jendso/bvab048.1996
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1210/jendso/bvab048.1996
Background: Subclinical hypothyroidism is common in older individuals, but the physiologic responses to treatment with levothyroxine (LT4) and liothyronine (LT3) are not well defined in this age group. Methods: We conducted a randomized, double-blind, cross-over study of LT4 and LT3 treatment in men and women aged 70 years and over without anti-thyroid peroxidase antibodies with persistent subclinical hypothyroidism, defined as having a TSH level between 4.5 and 19.9 µIU/mL with a normal free thyroxine (FT4) level at two consecutive time points. Physiologic outcome measures assessed after achieving a TSH level of 0.5-1.5 µIU/mL with each therapy included vital signs, weight and body composition, bone mineral content and bone density, lipids, resting energy expenditure (REE), cognitive function, quality of life, and thyroid symptoms. Results: Thirteen participants [mean (SD) age 77 (5) years], 4 women and 9 men, completed the study. Baseline mean TSH was 4.84 (1.29) µIU/mL. The mean LT4 dose was 105 (36) µg/day [1.4 (0.5) µg/kg/day] and LT4 dose was 34 (9) µg/day [0.4 (0.1) µg/kg/day]. Mean time on LT4 was 200 days and on LT3 was 231 days, with a 28 day washout period. Compared with baseline, participants had an average weight loss of 1.1 kg on LT4 (p<0.02) and 2.5 kg on LT3 (p<0.001), which was significantly different between the two treatments (p=0.01). Fat mass decreased by an average of 0.7 kg on LT4 (p=0.03 vs. baseline) and 1.5 kg on LT3 (p<0.01 vs. baseline) and differed between treatments (p=0.01). There was a significant difference in total cholesterol of 13.3 mg/dL (p<0.001) and in low-density lipoprotein cholesterol (LDL) of 10.8 mg/dL (p<0.001) between LT4 and LT3 treatment arms; for both, the levels were lower on LT3 than LT4. No differences were seen in the other assessed outcomes. Conclusions: In a cross-over study of treatment of LT4 or LT3 in persistent subclinical hypothyroidism, participants lost fat mass and weight after each treatment, with a greater decrease after treatment with LT3. These findings support different physiologic responses to LT4 compared with LT3.
Related Topics
Concepts
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1210/jendso/bvab048.1996
- https://academic.oup.com/jes/article-pdf/5/Supplement_1/A976/37203455/bvab048.1996.pdf
- OA Status
- gold
- Cited By
- 1
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W3158531061
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W3158531061Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1210/jendso/bvab048.1996Digital Object Identifier
- Title
-
Physiologic Effects of Levothyroxine and Liothyronine in the in Older Individuals With Persistent Subclinical Hypothyroidism: A Randomized, Double-Blind, Cross-Over StudyWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2021Year of publication
- Publication date
-
2021-05-01Full publication date if available
- Authors
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Paige Meizlik, Andrew J. Cucchiara, Lakshmi Kannan, Jarvis C. Mays, Jennifer F. Jolivert, Theresa Scattergood, Anne Rentoumis CappolaList of authors in order
- Landing page
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https://doi.org/10.1210/jendso/bvab048.1996Publisher landing page
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-
https://academic.oup.com/jes/article-pdf/5/Supplement_1/A976/37203455/bvab048.1996.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
-
https://academic.oup.com/jes/article-pdf/5/Supplement_1/A976/37203455/bvab048.1996.pdfDirect OA link when available
- Concepts
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Levothyroxine, Medicine, Subclinical infection, Internal medicine, Thyroid function tests, Thyroid function, Thyroid peroxidase, Endocrinology, Thyroid, Randomized controlled trial, PediatricsTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
1Total citation count in OpenAlex
- Citations by year (recent)
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2022: 1Per-year citation counts (last 5 years)
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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| best_oa_location.pdf_url | https://academic.oup.com/jes/article-pdf/5/Supplement_1/A976/37203455/bvab048.1996.pdf |
| best_oa_location.version | publishedVersion |
| best_oa_location.raw_type | journal-article |
| best_oa_location.license_id | https://openalex.org/licenses/cc-by-nc-nd |
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| best_oa_location.is_published | True |
| best_oa_location.raw_source_name | Journal of the Endocrine Society |
| best_oa_location.landing_page_url | https://doi.org/10.1210/jendso/bvab048.1996 |
| primary_location.id | doi:10.1210/jendso/bvab048.1996 |
| primary_location.is_oa | True |
| primary_location.source.id | https://openalex.org/S2735747656 |
| primary_location.source.issn | 2472-1972 |
| primary_location.source.type | journal |
| primary_location.source.is_oa | True |
| primary_location.source.issn_l | 2472-1972 |
| primary_location.source.is_core | True |
| primary_location.source.is_in_doaj | True |
| primary_location.source.display_name | Journal of the Endocrine Society |
| primary_location.source.host_organization | https://openalex.org/P4310315851 |
| primary_location.source.host_organization_name | Endocrine Society |
| primary_location.source.host_organization_lineage | https://openalex.org/P4310315851 |
| primary_location.source.host_organization_lineage_names | Endocrine Society |
| primary_location.license | cc-by-nc-nd |
| primary_location.pdf_url | https://academic.oup.com/jes/article-pdf/5/Supplement_1/A976/37203455/bvab048.1996.pdf |
| primary_location.version | publishedVersion |
| primary_location.raw_type | journal-article |
| primary_location.license_id | https://openalex.org/licenses/cc-by-nc-nd |
| primary_location.is_accepted | True |
| primary_location.is_published | True |
| primary_location.raw_source_name | Journal of the Endocrine Society |
| primary_location.landing_page_url | https://doi.org/10.1210/jendso/bvab048.1996 |
| publication_date | 2021-05-01 |
| publication_year | 2021 |
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