Objective: To demonstrate the effectiveness and compliance to L-thyroxine in the treatment of hypothyroidism in a weekly dose of seven times of normal dose as an alternative to daily dosing in young and middle aged females.
Methods: Randomized trial on 40 female patients aged between 25 to 55 years with long standing hypothyroidism of 5 years or more, currently on daily dose of L-thyroxine, were assigned weekly dose of seven times of normal dose. The patients were randomized in 2 groups G1 and G2.
G1: 20 Female patients with an established diagnosis of hypothyroidism of 5 years or more with TSH value of 4.2 μIU/l or less, currently on daily dose. The patients were assigned a weekly dose of L-thyroxine which was changed to seven times of normal dose.
G2: 20 Female patients with an established diagnosis of hypothyroidism of 5 years or more with elevated TSH value of more than 4.2 μIU/l. The dose in this group was individualized as per the body weight and TSH value.
All patients in both the groups were screened for malabsorption and were not receiving any drugs which interfere with the absorption of L-thyroxine. The minimum to maximum dose of L-thyroxine used in this study was 1751050 μg.
Results: We achieved complete restoration of euthyroidism in all 20 patients in the G1 at D 84 and it continued to D 168. In G2 we achieved complete euthyroidism in 16 patients at D 84 and it increased to 18 patients with some dose adjustment at D 168. We could not achieve euthyroidism in 2 patients at D 168. The unlike cause can be attributed to other metabolic disorders like diabetes and obesity.
Conclusion: Once weekly dose of L-thyroxine as an alternative to daily dosing regimen was shown to be efficacious and safe for the treatment of hypothyroidism in young and middle aged females. Once a week L-thyroxine can be considered as a first line therapy in young and middle aged working females facing impaired absorption due to early breakfast (no need to wait 3045 min for breakfast).
18 - 21 May 2019
European Society of Endocrinology