Administration of Thyroxin Once a Week*

Sekadde, Christine B.; Slaunwhite, W. Roy; Aceto, Thomas; Murray, Kathleen

doi:10.1210/jcem-39-4-759

Cited by 22 publications

(12 citation statements)

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“…Although serum FT 4 levels rose significantly after treatment, changes in FT 3 with once weekly therapy were slight, confirming previous studies (9,11,13). Once weekly T 4 replacement was well tolerated, and there was no indication of acute treatment toxicity compared with daily therapy.…”

Section: Discussionsupporting

confidence: 84%

“…In addition, the absence of data on thyroid function tests and tissue markers during days 2-6 after weekly treatment in our study could underestimate the toxicity of weekly treatment. However, other studies have suggested that T 4 doses between 2.4 -300 mg will lead to a T 3 peak before 24 h (11,39). However, other studies have suggested that T 4 doses between 2.4 -300 mg will lead to a T 3 peak before 24 h (11,39).…”

Section: Discussionmentioning

confidence: 97%

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Treatment of Hypothyroidism with Once Weekly Thyroxine¹

Grebe

Cooke²,

Ford³

et al. 1997

The Journal of Clinical Endocrinology & Metabolism

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We compared daily T4 therapy with 7 times the normal daily dose administered once weekly in 12 hypothyroid subjects in a randomized cross-over trial. At the end of each treatment we measured serum free T4 (FT4), free T3 (FT3), rT3, and TSH levels and multiple markers of thyroid hormone effects at the tissue level repeatedly for 24 h. Compared with daily administration, the mean serum TSH before the administration of weekly T4 was higher (weekly, 6.61; daily, 3.92 microIU/mL; P < 0.0001), and the mean FT4 (weekly, 0.98; daily, 1.35 ng/dL; P < 0.01) and FT3 (weekly, 208, daily, 242 pg/dL; P < 0.01) were lower. A minimally elevated serum total cholesterol during weekly administration (weekly, 246.8; daily, 232.6 mg/dL; P < 0.03) was the only evidence of hypothyroidism at the tissue level. Compared with daily administration, the mean peak FT4 following weekly administration of T4 was significantly higher (weekly, 2.71; daily, 1.59 ng/dL; P < 0.0001), as was the mean peak FT3 level (weekly, 285; daily, 246 pg/dL; P < 0.01). None of the tissue markers of thyroid hormone effect changed compared to daily T4, and there was no evidence of treatment toxicity, including cardiac toxicity. During weekly T4 administration, autoregulatory mechanisms maintain near-euthyroidism. For complete biochemical euthyroidism a slightly larger dose than 7 times the normal daily dose may be required.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 97%

Treatment of Hypothyroidism with Once Weekly Thyroxine¹

Grebe

Cooke²,

Ford³

et al. 1997

The Journal of Clinical Endocrinology & Metabolism

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“…Some recent series evaluating hypothyroid patients with poor control have shown that adequate thyroid hormone levels were obtained after introducing weekly LT4 (17,19,20,22). However, cardiovascular side effects were not thoroughly investigated in these reports.…”

Section: Introductionmentioning

confidence: 99%

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

Bornschein

Paz-Filho

Graf

et al. 2012

Arq Bras Endocrinol Metab

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Objective: Compliance to levothyroxine treatment in hypothyroidism is compromised by daily schedule, and a weekly dose may be an alternative. Subjects and methods: This was a randomized, crossover study. Fourteen females were assigned to daily or weekly doses of LT4. After six weeks, they switched regimens. Thyroid parameters were measured at baseline, and after 42 and 84 days. Echocardiogram and hyperthyroidism symptoms were evaluated before and four hours after LT4 intake. Results: In the weekly dose treatment, fT4 levels were higher after taking LT4, and lower seven days after the last dose; by the 6 th week there was a small decrease in T3 levels. TSH remained unchanged and there were no hyperthyroidism symptoms or echocardiographic manifestations. Conclusion: Weekly dose leads to transient increases in fT4, without hyperthyroidism or cardiac symptoms. That approach seems to be a safe alternative for the treatment of hypothyroidism. Arq Bras Endocrinol Metab. 2012;56(4):250-8 Keywords Adhesion; dosing; thyroid; treatment ReSUMO Objetivo: Aderência ao tratamento do hipotiroidismo é comprometido pelo uso diário de levotiroxina, e doses semanais poderiam ser uma alternativa. Sujeitos e métodos: Este é um estudo randomizado, crossover. Quatorze mulheres foram selecionadas para receber LT4 diariamente ou semanalmente. Após seis semanas, houve inversão do regime de tratamento. Avaliações tireoideanas foram realizadas antes, após 42 e 84 dias. Avaliação de sintomas de hipertireoidismo e ecocardiograma foi realizada antes e após quatro horas de LT4. Resultados: Com dose semanal, os níveis de fT4 foram mais elevados logo após a dose de LT4, e menores após sete dias; após seis semanas, houve diminuição de T3. TSH permaneceu inalterado e não houve manifestações ecocardiográficas ou de hipertireodismo. Conclusão: Dose semanal de LT4 leva à elevação de fT4, sem manifestações de hipertireoidismo, e parece ser uma alternativa segura para o tratamento do hipotireoidismo. Arq Bras Endocrinol Metab. 2012;56(4):250-8

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“…Thyroxine has been used to treat nontoxic goitre since 1896, when the first reports of its favourable influence on goitre size were published (Astwood et al, 1960;Badillo et a[., 1963;Glassford et al, 1965;Hansen et a/., 1979;Perrild et a/., 1982). Thyroxine is now given also after operation for nontoxic goitre, with the aim of preventing recurrence (Bergfelt & Risholm, 1963;Bernstein & Robbins, 1969;Sekadde et al, 1974;Noel & Beckers, 1978;Goretzki et af., 1981).…”

mentioning

confidence: 99%

Recurrence of Nontoxic Goitre With and Without Postoperative Thyroxine Medication

Geerdsen

Frølund

1984

Clinical Endocrinology

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The incidence of postoperative recurrence of nontoxic goitre was evaluated in 175 patients. The average observation period was 8.8 years. Levothyroxine (Eltroxin) had been taken by 104 of these patients as long-term prophylaxis against goitre recurrence. Ten (9.5%) of the 104 had recurrence. The other 71 patients received no or only brief thyroxine medication postoperatively. In this group there were eight recurrences (11.3%). The difference was not significant, nor did the two groups differ significantly in regard to sex and age distribution, pathologic anatomy and observation time. Routine long-term administration of thyroxine after thyroid resection is not justified from the results of this study.

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Administration of Thyroxin Once a Week*

Cited by 22 publications

References 0 publications

Treatment of Hypothyroidism with Once Weekly Thyroxine¹

Treatment of Hypothyroidism with Once Weekly Thyroxine¹

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

Recurrence of Nontoxic Goitre With and Without Postoperative Thyroxine Medication

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Administration of Thyroxin Once a Week*

Cited by 22 publications

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Treatment of Hypothyroidism with Once Weekly Thyroxine1

Treatment of Hypothyroidism with Once Weekly Thyroxine1

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

Recurrence of Nontoxic Goitre With and Without Postoperative Thyroxine Medication

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Treatment of Hypothyroidism with Once Weekly Thyroxine¹

Treatment of Hypothyroidism with Once Weekly Thyroxine¹