Levothyroxine Replacement Therapy and Overuse: A Timely Diagnostic Approach

Thyroid ◽  
2018 ◽  
Vol 28 (12) ◽  
pp. 1580-1586 ◽  
Author(s):  
Sarantis Livadas ◽  
Christina Bothou ◽  
Ioannis Androulakis ◽  
Anastasios Boniakos ◽  
Nicholas Angelopoulos ◽  
...  
Keyword(s):  
Replacement Therapy ◽  
Diagnostic Approach ◽  
Levothyroxine Replacement

Response to Michalaki et al. re: “Levothyroxine Replacement Therapy and Overuse: A Timely Diagnostic Approach”

Thyroid ◽  
2019 ◽  
Vol 29 (8) ◽  
pp. 1169-1169
Author(s):  
Sarantis Livadas ◽  
Christina Bothou ◽  
Ioannis Androulakis ◽  
Anastasios Boniakos ◽  
Nicholas Angelopoulos ◽  
...  
Keyword(s):  
Replacement Therapy ◽  
Diagnostic Approach ◽  
Levothyroxine Replacement

Re: “Levothyroxine Replacement Therapy and Overuse: A Timely Diagnostic Approach” by Livadas et al.(Thyroid 2018:28;1580–1586)

Thyroid ◽  
2019 ◽  
Vol 29 (8) ◽  
pp. 1168-1168 ◽  
Author(s):  
Marina A. Michalaki ◽  
Apostolos G. Vagenakis ◽  
Kostas B. Markou
Keyword(s):  
Replacement Therapy ◽  
Diagnostic Approach ◽  
Levothyroxine Replacement

scholarly journals Long-Term Cardiovascular Effects of Levothyroxine Therapy in Young Adults with Congenital Hypothyroidism

2008 ◽  
Vol 93 (7) ◽  
pp. 2486-2491 ◽  
Author(s):  
Mariacarolina Salerno ◽  
Ugo Oliviero ◽  
Teresa Lettiero ◽  
Vincenzo Guardasole ◽  
Dario Maria Mattiacci ◽  
...  
Keyword(s):  
Young Adults ◽  
Replacement Therapy ◽  
Exercise Capacity ◽  
Congenital Hypothyroidism ◽  
Intima Media Thickness ◽  
Normal Range ◽  
Levothyroxine Replacement ◽  
Levothyroxine Treatment ◽  
Tsh Levels

Abstract Context: Congenital hypothyroidism (CH) is the most prevalent endocrine disorder in the newborn and is routinely treated with life-long levothyroxine replacement therapy. Although several studies have demonstrated that such therapy may impact on the cardiovascular system, little is known with regard to the effects of long-term levothyroxine administration in patients with CH. Objective: The aim of the current study was to evaluate whether long-term levothyroxine replacement therapy in young adults with CH is associated with cardiovascular abnormalities. Patients and Methods: Thirty young adults with CH aged 18.1 ± 0.2 yr and 30 age- and sex-matched controls underwent cardiac and carotid Doppler ultrasound and symptom-limited cardiopulmonary exercise testing. Hypothyroidism was diagnosed by neonatal screening, and levothyroxine treatment was initiated within the first month of life and carefully adjusted to maintain TSH levels in the normal range and free T4 in the high-normal range. Results: Compared with controls, hypothyroid patients exhibited left ventricular diastolic dysfunction, impaired exercise capacity, and increased intima-media thickness. At multiple regression analysis, the number of episodes of plasma TSH levels less than 0.5 mU/liter and greater than 4.0 mU/liter from the age of 1 yr onward, and mean TSH plasma levels during puberty were independent predictors of diastolic filling and cardiopulmonary performance indexes (multiple r values: 0.61–0.75). Conclusions: Long-term levothyroxine treatment in young adults with congenital hypothyroidism is associated with impaired diastolic function and exercise capacity and increased intima-media thickness.

scholarly journals Thyroid hormones modulate irisin concentrations in patients with recently onset hypothyroidism following total thyroidectomy

2020 ◽  
Author(s):  
R. Bocale ◽  
A. Barini ◽  
A. D‘Amore ◽  
M. Boscherin ◽  
S. Necozione ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Thyroid Hormones ◽  
Total Thyroidectomy ◽  
Replacement Therapy ◽  
Thyroid Function ◽  
Multivariate Regression ◽  
Multivariate Regression Analysis ◽  
Levothyroxine Replacement ◽  
Circulating Levels

Abstract Purpose Irisin is a newly discovered adipo-myokine known for having significant effects on body metabolism. Currently, there is a discussion regarding the relation between thyroid function and irisin concentration. This study was designed to evaluate the influential role of levothyroxine replacement therapy on circulating levels of irisin in patients with recently onset hypothyroidism following total thyroidectomy. Methods Circulating levels of thyroid hormones, irisin and other metabolic parameters, were assessed in 40 recently thyroidectomized patients (34 females, mean age 50.1 ± 15.2 years) at baseline (5–7 day after surgery) and after 2 months under replacement therapy with levothyroxine. Results At baseline, circulating levels of thyroid hormones were indicative of hypothyroidism (TSH 12.7 ± 5.0 μU/mL, FT3 1.9 ± 0.7 pg/mL, FT4 8.7 ± 3.6 pg/mL). Mean serum irisin concentrations significantly increased after 2 months under replacement therapy with levothyroxine (from 2.2 ± 0.6 to 2.9 ± 0.6 μg/mL, p < 0.0001). Variations of circulating levels of irisin under levothyroxine replacement therapy were directly correlated with those of FT3 (Rho = 0.454, p = 0.0033) and FT4 (Rho = 0.451, p = 0.0035). Multivariate regression analysis revealed that changes in thyroid hormones concentrations explained up to 10% of the variations of serum irisin levels under levothyroxine replacement therapy (FT3 R2 = 0.098, FT4 R2 = 0.103). Conclusion Our study suggests that levothyroxine replacement therapy mildly influences irisin metabolism in patients with recently onset hypothyroidism following total thyroidectomy.

scholarly journals Benefits of Levothyroxine Replacement Therapy on Nonalcoholic Fatty Liver Disease in Subclinical Hypothyroidism Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Lu Liu ◽  
Yong Yu ◽  
Meng Zhao ◽  
Dongmei Zheng ◽  
Xu Zhang ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Replacement Therapy ◽  
Nonalcoholic Fatty Liver Disease ◽  
Subclinical Hypothyroidism ◽  
Fatty Liver Disease ◽  
Controlled Trial ◽  
Effective Means ◽  
Nonalcoholic Fatty Liver ◽  
Levothyroxine Replacement

Objectives. To evaluate the effect of levothyroxine (LT4) replacement therapy on nonalcoholic fatty liver disease (NAFLD) in subclinical hypothyroidism (SCH) patients.Methods. This study was a post hoc analysis of a randomized controlled trial and involved 33 significant and 330 mild SCH patients. All of the significant SCH patients received LT4supplement. The mild SCH patients were grouped as LT4treated or not. After 15 months of follow-up, prevalence of NAFLD in each group was reevaluated. Subgroup analysis was conducted in mild SCH patients with dyslipidemia.Results. After treatment with LT4, the prevalence of NAFLD in significant SCH patients reduced from 48.5% to 24.2% (p=0.041). In mild SCH patients, prevalence of NAFLD and serum alanine aminotransferase (ALT) was not significantly affected by LT4supplementation. Nonetheless, mild SCH patients with dyslipidemia who received LT4treatment experienced decreases in the prevalence of NAFLD and serum ALT levels (p<0.05for both). In contrast, these parameters remained comparably stable in patients who were not treated.Conclusion. LT4supplementation has benefits on NAFLD in significant SCH patients or mild SCH patients with dyslipidemia. For NAFLD patients with SCH, appropriate supplementation of LT4may be an effective means of controlling NAFLD. The original trial was registered with ClinicalTrials.gov (NCT01848171).

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