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Cited by 151Thyroid Disorders and TreatmentsThyroid and Parathyroid SurgeryHormonal and reproductive studies

The DOI matches its Crossref record; 48 of the 49 references it cites were found in a registry or an index.

The Starting Dose of Levothyroxine in Primary Hypothyroidism Treatment: A Prospective, Randomized, Double-blind Trial

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Roos, Annemieke, Linn-Rasker, Suzanne P., van Domburg, Ron T., Tijssen, Jan P., Berghout, Arie·2005·Archives of Internal Medicine
DOI 10.1001/archinte.165.15.1714
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Abstract

BACKGROUND: The treatment of hypothyroidism with levothyroxine is effective and simple; however, recommendations for the starting dose vary considerably. To our knowledge, the levothyroxine starting dose has never been studied prospectively. METHODS: We conducted a prospective, randomized, double-blind trial that compared a full starting levothyroxine dose of 1.6 mug/kg with a low starting dose of 25 mug (increased every 4 weeks) in patients with newly diagnosed cardiac asymptomatic hypothyroidism. Safety was studied by documenting cardiac symptoms and events, and efficacy was studied by monitoring thyrotropin and free thyroxine levels and by assessing improvement of signs and symptoms and quality of life. RESULTS: Seventy-five consecutive patients were enrolled, of whom 50 underwent randomization. At baseline, the severity of hypothyroidism and age were comparable in the full-dose (n = 25) vs the low-dose group (n = 25): thyrotropin, 61 vs 48 mIU/L; free thyroxine, 0.56 vs 0.64 ng/dL (7.2 vs 8.2 pmol/L); and age, 47 vs 47 years. No cardiac complaints or events were documented during treatment or at bicycle ergometry at baseline, 12 weeks, or 24 weeks. Euthyroidism was reached in the full-dose vs the low-dose group in 13 vs 1 (4 weeks), 19 vs 3 (8 weeks), 19 vs 9 (12 weeks), 20 vs 14 (16 weeks), 20 vs 18 (20 weeks), and 21 vs 20 (24 weeks) patients (P = .005). However, signs and symptoms of hypothyroidism and quality of life improved at a comparable rate. CONCLUSION: A full starting dose of levothyroxine in cardiac asymptomatic patients with primary hypothyroidism is safe and may be more convenient and cost-effective than a low starting dose regimen.

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Metadata

Authors
Roos, A., Linn-Rasker, S. P., van Domburg, R. T., Tijssen, J. P., & Berghout, A.
Affiliations
Erasmus MC (NL)
Venue
Archives of Internal Medicine
Publisher
American Medical Association (AMA)
Published
2005-08-08
Volume
165
Issue
15
Pages
1714
ISSN
0003-9926 (ISSN-L)
DOI
10.1001/archinte.165.15.1714
OpenAlex
W2126532627
Cited by
150
References
49
Citations by year
2026: 1 · 2025: 12 · 2024: 5 · 2023: 12 · 2022: 12 · 2021: 9 · 2020: 4 · 2019: 10 · 2018: 2 · 2017: 6 · 2016: 9 · 2015: 7 · 2014: 6 · 2013: 6 · 2012: 13
FWCI
3.10
Type
journal article
Language
en
Open access
Licence
other-oa
Locations
  • Archives of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
  • Pure Amsterdam UMC (submittedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
Keywords
levothyroxine, primary hypothyroidism, starting dose, euthyroidism, thyroid-stimulating hormone, free thyroxine, quality of life, hypothyroidism symptoms, treatment safety
MeSH terms
Adult, Aged, Double-Blind Method, Half-Life, Humans, Hypothyroidism, Male, Middle Aged, Prospective Studies, Quality of Life, Thyrotropin, Thyroxine

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