ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 63 P1227 | DOI: 10.1530/endoabs.63.P1227

Beneficial and fast impact of intravenous levothyroxine therapy on the lipid profile in severe hypothyroid patients

Pablo Trincado Aznar1, María Martínez García1, Beatriz Lardiés Sánchez2, María Elena López Alaminos1, Almendra Alvarado Rosas1, Isabel Azcona Monreal1, Patricia de Diego García1 & Concepción Zapata Adiego1


1Hospital Universitario Miguel Servet, Zaragoza, Spain; 2Hospital Obispo Polanco, Teruel, Spain.


Introduction: Abnormalities of lipid metabolism and arterial hypertension occur with increased frequency in hypothyroidism and are associated with a higher risk of premature atherosclerotic vascular disease. Therefore, a vigorous lipid lowering treatment seems mandatory, including quickly restoration of thyroid function, to reduce vascular risk. We evaluate benefits on lipid profile after intravenous thyroxine treatment in severe hypothyroid patients at three and thirty days.

Material and methods: Our retrospective study includes 70 consecutive severe hypothyroid patients (mean TSH of 104.1 mUI/L (±34.6)) treated with intravenous levothyroxine from 2004 to 2018 at our institution with a mean dose of 433.3 micrograms in two days and afterwards treated orally with a standard replacement dose. Total cholesterol, LDL-c, HDL-c, triglycerides, creatinine and CPK were measured on days 2–3 and 30 after treatment. No extra lipid lowering agents were used during the study. Data were analyzed with the Statistical Package for Social Science (SPSS), version 20.0 (SPSS Inc., Chicago, IL).

Results

Mean (+ SD) at admissionMean (+ SD) at 2°-3° dayMean (+ SD) at 30 daysP
Total Cholesterol (mg/dl)273.5 (+93.1)231.13 (+86.1)175.6 (+42.2)<0.05
HDL-c (mg/dl)65.7 (+29.7)57.4 (+21.1)50.78 (+14.1)<0.05
LDL-c (mg/dl)166.8 (+60.3)143.6 (+57.8)104.5 (+36.1)<0.05
Triglycerides (mg/dl)151.24 (+28.2)130.2 (+31.9)106.3 (+50.5)<0.05
Creatinine (mg/dl)1.14 (+0.4)1.1 (+0.3)1.0 (+0.4)<0.05
CPK (U/L)805.7 (+119.2)453.7 (+59.6)-<0.05

Mean (+ SD) at admissionMean (+ SD) at 2°-3° dayMean (+ SD) at 30 daysP
Total Cholesterol (mg/dl)273.5 (+93.1)231.13 (+86.1)175.6 (+42.2)<0.05
HDL-c (mg/dl)65.7 (+29.7)57.4 (+21.1)50.78 (+14.1)<0.05
LDL-c (mg/dl)166.8 (+60.3)143.6 (+57.8)104.5 (+36.1)<0.05
Triglycerides (mg/dl)151.24 (+28.2)130.2 (+31.9)106.3 (+50.5)<0.05
Creatinine (mg/dl)1.14 (+0.4)1.1 (+0.3)1.0 (+0.4)<0.05
CPK (U/L)805.7 (+119.2)453.7 (+59.6)-<0.05

Conclusions: Lipid profile in severe hypothyroid patients shows a fast response in 48 hours to intravenous levothyroxine with marked improvement in all parameters.