ECE2020 Audio ePoster Presentations Thyroid (144 abstracts)
Effect of increased levothyroxine dose on depressive mood in older adults undergoing thyroid hormone replacement therapy
Jae Hoon Moon 1 , Ji Won Han 2 , Tae Jung Oh 1 , Sung Hee Choi 1 , Soo Lim 1 , Ki Woong Kim 2 & Hak Chul Jang 1
1Seoul National University Bundang Hospital and Seoul National University College of Medicine, Department of Internal Medicine, Seongnam-si, Korea, Republic of South; 2Seoul National University Bundang Hospital and Seoul National University College of Medicine, Department of Neuropsychiatry, Seongnam-si, Korea, Republic of South
Background: Depressive mood consequent to hypothyroidism can be reversed with levothyroxine (LT4) replacement therapy. However, it is unclear whether increasing LT4 dose confers additional mood benefits.
Methods: This was a single-blind before-and-after study of 26 patients with hypothyroidism who were aged 65 years or older and undergoing LT4 replacement therapy. Geriatric Depression Scale (GDS-K) and Hyperthyroid Symptom Scale (HSS-K) were assessed at baseline, 3 months after increasing LT4 dose by an additional 12.5 µg/day, and finally 3 months after returning to the baseline dose.
Results: Systolic blood pressure and pulse rate increased from baseline with the increased LT4 dose, and recovered after returning to the baseline dose. Serum thyroid-stimulating hormone (TSH) concentrations decreased at the higher LT4 dose (1.95 ± 2.16 vs 0.47 ± 1.09 mIU/l, P < 0.001) and recovered after returning to the baseline dose. Serum-free thyroxine levels and HSS-K scores were unchanged during the study period. GDS-K scores improved on the increased dose (9.5 ± 6.6 vs 7.5 ± 4.7, P = 0.029) and this improvement was maintained after returning to the baseline dose (9.5 ± 6.6 vs 7.4 ± 5.4, P = 0.010). Higher serum TSH was independently associated with both higher GDS-K and depression risk among those with depressive mood (GDS-K > 10) at baseline.
Conclusions: Depressive mood improves with increased LT4 dose, without significant hyperthyroid symptoms or signs, in older adults undergoing thyroid hormone replacement. These findings suggest the potential for varying hypothyroid treatment based on mood status, and that low-dose LT4 treatment may be used as an ancillary treatment in older euthyroid patients with depression.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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