TSH evaluation in hypothyroid patients assuming liquid levothyroxine at breakfast or 30 min before breakfast
Abstract
Purpose To compare TSH levels of hypothyroid patients treated with liquid LT4 at breakfast or 30 min before breakfast.Patients and methods Subjects, aged 18-75 years old, were eligible if they presented hypothyroidism, due to Hashimoto's thyroiditis or after thyroidectomy for proven benign goiter. Seven hundred ninety-eight patients were recruited and enrolled in the study. Thirty-seven subjects withdrew from the trial. A total of 761 patients (mean age 46.2 ± 10.8 years) completed the study. The starting dose of LT4 was determined through clinical judgment, taking into account TSH levels, estimated residual thyroid function, age, body weight and comorbidities. All patients underwent TSH, fT4, and fT3 evaluation to verify achievement of euthyroidism with their initial fasting state assumption of LT4 after 8 weeks of therapy. If euthyroidism was not achieved, an appropriately adjusted LT4 dose was administered for 8 weeks, after which thyroid function parameters were checked again. If euthyroidism was achieved, the patients were asked to take LT4 at breakfast and hormone levels were checked again after 6 months.Results At the end of the study period, no significant differences in serum TSH level were observed whether LT4 was ingested at breakfast or 30 min prior in a fasting state: 2.61 ± 1.79 vs. 2.54 ± 1.86 mIU/L, respectively (p = 0.455).Conclusions This study confirms in a large set of patients that a liquid LT4 formulation can be taken directly at breakfast and potentially improve therapeutic compliance.
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Several prospective or retrospective studies also showed similar results to the 2016 trial.
“Several prospective or retrospective studies also showed similar results (206–209).”
From Levothyroxine: conventional and novel drug delivery formulations. (2023) · cites this paper as [209]
Taken together, the convenience of the liquid preparation improves patient compliance.
“Taken together, these data show that the convenience of the liquid preparation improves patient compliance.”
From Levothyroxine: conventional and novel drug delivery formulations. (2023) · cites this paper as [209]
Pirola et al. study of 4 hypothyroid patients treated with liquid LT4 did not find significant differences in serum TSH according to whether LT4 was taken 30 min before breakfast or at breakfast.
“Pirola et al. study of 4 hypothyroid patients treated with liquid LT4 did not find any significant differences in the serum TSH level according to whether the LT4 was taken 30 min before breakfast or at breakfast [ 28 ].”
From Factors influencing the levothyroxine dose in the hormone replacement therapy of primary hypothyroidism in adults (2022) · cites this paper as [28]
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- Authors
- Pirola, I., Gandossi, E., Brancato, D., Marini, F., Cristiano, A., Delbarba, A., Agosti, B., Castellano, M., & Cappelli, C.
- Affiliations
- Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT)
- Corresponding author
- Cappelli, C.
- Venue
- Journal of Endocrinological Investigation
- Published
- 2018-03-26
- Volume
- 41
- Issue
- 11
- Pages
- 1301-1306
- ISSN
- 0391-4097 (ISSN-L)
- 1720-8386
- OpenAlex
- W2790014087
- Cited by
- 21
- References
- 27
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 3 · 2022: 4 · 2021: 3 · 2020: 4 · 2019: 1 · 2018: 2
- FWCI
- 1.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Endocrinological Investigation (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System (Università degli Studi di Brescia) (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 › Thyroid Cancer Diagnosis and Treatment
- Keywords
- hypothyroidism, levothyroxine, TSH levels, Hashimoto's thyroiditis, thyroidectomy, euthyroidism, medication adherence, thyroid hormone replacement
- MeSH terms
- Adult, Drug Administration Schedule, Fasting, Female, Humans, Hypothyroidism, Male, Middle Aged, Thyrotropin, Thyroxine, Treatment Outcome, Hormone Replacement Therapy, Breakfast
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