Treating primary hypothyroidism with weekly doses of levothyroxine: a randomized, single-blind, crossover study

Bornschein, Andressa; Paz-Filho, Gilberto; Graf, Hans; Carvalho, Gisah Amaral de

doi:10.1590/s0004-27302012000400006

Cited by 22 publications

(44 citation statements)

References 33 publications

(29 reference statements)

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“…The thyroid function tests also continued to be within acceptable limits at all 3 follow up visits in both study arms, suggesting biochemical euthyroidism status with alternate day therapy. Our observations are similar to some earlier studies in older patients with hypothyroidism (6, 7). However due to financial constraints we could not estimate free T3 and free T4 levels which were measured by the previous investigators.…”

Section: Discussionsupporting

confidence: 93%

“…In addition, there is a strong evidence of auto regulation of peripheral conversion of thyroxine (T4) to triiodothyronine (T3) with increasing conversion rates at low serum T4 levels and decreasing conversion when T4 is elevated (5). Also, large doses of thyroxine are usually well tolerated (6-8). Together these properties suggest the possibility of using dosing intervals longer than the traditional 24 hours.…”

Section: Introductionmentioning

confidence: 99%

“…To circumvent aforementioned problems of a weekly regimen, a twice weekly dosing schedule has been suggested (10). The studies on longer dosing regimens in hypothyroidism have only been conducted in adult patients (6-8). In fact weekly or biweekly regimens may not be ethically justifiable in children due to concerns about growth and development.…”

Section: Introductionmentioning

confidence: 99%

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Daily versus Alternate Day ThyroxineTherapy to Maintain Euthyroidism in Children with Congenital Hypothyroidism

Dayal

Saini

Attri

et al. 2013

Int J Endocrinol Metab

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Background:Daily administration of thyroxine has proven efficacy in treatment of children with hypothyroidism. However, the possibility of treatment with longer dosing intervals that offers flexibility and choice in maintaining euthyroid state has not been tested in children.Objectives:To study the efficacy of an alternate day regimen to maintain euthyroidism in children with congenital hypothyroidismPatients and Methods:Forty patients given alternate day therapy, while 30 children continued on their daily regimen were followed up at monthly intervals for 3 months. Clinical and laboratory assessments were performed at each follow up visit.Results:The clinical and anthropometric parameters remained similar in both groups of patients during the study indicating a maintained euthyroid state clinically. The thyroid profiles also remained within normal limits suggesting biochemical euthyroidism status with alternate day therapy. However the baseline serum aminotransferase levels showed mild elevation in patients on alternate day regimen and the difference persisted during the follow up visits. Higher HDL and lower TC and LDL levels suggested some beneficial effect of alternate day schedule on lipid profiles.Conclusions:In short-term, alternate day schedule can be effectively used to maintain clinical and biochemical euthyroid state in children with congenital hypothyroidism beyond 4 years of age.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Daily versus Alternate Day ThyroxineTherapy to Maintain Euthyroidism in Children with Congenital Hypothyroidism

Dayal

Saini

Attri

et al. 2013

Int J Endocrinol Metab

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“…In a study on 14 patients, Bornschein et al [10] showed similar results and did not observe any hyperthyroidism during weekly therapy. A study done on Asian hypothyroid patients by Doraiswamy and Zainudin [11] demonstrated that after 3 months, there were no significant differences in thyroid profile between the weekly and daily groups.…”

Section: Discussionmentioning

confidence: 68%

The Effect of Daily versus Weekly Levothyroxine Replacement on Thyroid Function Test in Hypothyroid Patients at a Tertiary Care Centre in Haryana

Rajput¹,

Pathak²

2017

Eur Thyroid J

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Objective: We compare the effect of daily versus weekly levothyroxine (LT4) replacement on thyroid function test (TFT) in hypothyroid patients at a tertiary care centre in Haryana. Materials and Methods: This was a randomised crossover study in which 100 hypothyroid patients on a stable LT4 dose were divided into 2 groups of 50 each. In group I, patients were given daily therapy for 6 weeks and then shifted to weekly therapy for the next 6 weeks. In group II, patients were given LT4 once a week for 6 weeks and then switched to daily therapy for the next 6 weeks. TFT, quality of life (QOL), and hyperthyroidism symptom scale (HSS) score of patients were compared in each group at 0, 6, and 12 weeks. Results: TFT remained within the normal range, but TSH increased (group I, daily 2.8 ± 1.4 mIU/L, weekly 3.9 ± 1.1 mIU/L, p = 0.001; group II, weekly 4.6 ± 1.1 mIU/L, daily 2.7 ± 1.2 mIU/L, p = <0.001) and T3/T4 decreased with weekly therapy as compared to daily therapy. No significant difference in HSS score was found between daily and weekly administration of LT4. With weekly therapy, QOL showed improvement in bodily pain, vitality, mental health, and social functioning. Conclusion: Once-weekly LT4 administration is a reasonable alternative for patients, especially for those who have issues with compliance.

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“…pylori density, neutrophils, monocytes, atrophy, intestinal metaplasia (IM) in the antrum and corpus into one of five grades (0 to 4). Samples at grade 1 or more were considered positive . Furthermore, H .…”

Section: Participantsmentioning

confidence: 99%

Prostate stem cell antigen gene TT genotype and development of intestinal metaplasia in Helicobacter pylori infection

Uotani

Sugimoto

Ichikawa

et al. 2016

J of Digest Diseases

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Aim Gastric cancer is etiologically related to interactions between Helicobacter pylori infection, environmental, and host factors. Gastric carcinoma is associated with a cascade of increasing atrophic gastric mucosal damage. Prostate stem cell antigen polymorphisms have been associated with an increased risk of gastric cancer. Here, we examined the interaction between prostate stem cell antigen polymorphisms and H. pylori in the progression of H. pylori gastritis. Methods Prostate stem cell antigen polymorphisms (TT, TC and CC) among H. pylori infected and uninfected Bhutanese were compared with the severity of H. pylori gastritis (neutrophils, monocytes, atrophy scores, H. pylori density, and the presence and extent of intestinal metaplasia) using the updated Sydney system. Results Biopsies from 339 patients were included. The proportion of biopsies with intestinal metaplasia was also significantly (P<0.05) greater among those with the TT genotype than with either the CT or CC genotype. Despite no significant differences in inflammation or H. pylori density scores, the scores for the premalignant condition, intestinal metaplasia in both the gastric corpus and antrum, among H. pylori infected with the TT genotype was significantly (P <0.05) greater than C allele carriers. Conclusions Prostate stem cell antigen TT genotype was associated with more than a 3-fold increase in the prevalence and extent of gastric mucosal intestinal metaplasia compared to C allele carriers among H. pylori infected Bhutanese.

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Treating primary hypothyroidism with weekly doses of levothyroxine: a randomized, single-blind, crossover study

Cited by 22 publications

References 33 publications

Daily versus Alternate Day ThyroxineTherapy to Maintain Euthyroidism in Children with Congenital Hypothyroidism

Daily versus Alternate Day ThyroxineTherapy to Maintain Euthyroidism in Children with Congenital Hypothyroidism

The Effect of Daily versus Weekly Levothyroxine Replacement on Thyroid Function Test in Hypothyroid Patients at a Tertiary Care Centre in Haryana

Prostate stem cell antigen gene TT genotype and development of intestinal metaplasia in Helicobacter pylori infection

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