Endocrine Abstracts (2011) 26 P414

Does levothyroxine plus thyrostatic drug titrated individually offer better control of hyperthyreoidism than thyrostatic alone?

Josip Žmire, Kristijan Peroš, Kristina Kljajić, Krešimir Martinac, Bože Čolak, Marijana Vučić Lovrenčić & Lea Sokolić

Clinical Hospital ‘Merkur’, Zagreb, Croatia.

In order to compare effects of treatment in hyperthyroid patients treated with thyrostatic drug alone and those treated with thyrostatic plus levothyroxine we reviewed data from 60 consecutive patients attending our outpatient clinic. 27 patients, 25 ♀ and 2 ♂, aged 27–68 years were treated with thyrostatic drug alone, while 33 patients, 31 ♀ and 2 ♂, aged 19–88 years received thyrostatic plus levothyroxine. Number of remissions was greater in thyrostatic plus levothyroxine group (16 vs 8) but these patients were treated for longer period than patients in thyrostatic only group: 8.2 years (1–21) vs 4.5 years (1–14). Number of euthyroid findings on every single visit in thyrostatic plus levothyroxine group – 68.34% – was greater than in thyrostatic alone group – 51.28%, but this did not reach statistical significance (P=0.28). Numbers of both hypothyroid and hyperthyroid findings were nonsignificantly greater in thyrostatic alone group – 29.09 vs 17.84% (P=0.47) and 24.17 vs 18.18% (P=0.80) respectively. Although number of hormone findings outside normal range may seem great it has no clinical impact on patients because over 90% findings do not deviate from euthroidism more than 25% what is generally symptom free. There were no serious side effects of drugs in both groups.

Authors conclude that addition of levothyroxine is inevitable in cases of discordant levels of thyroxine and triiodothyronine, when decreased thyroxine is accompanied by normal or even slightly elevated triiodothyronine irrespective of TSH values.

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