Comparison of effectiveness of thyrotropin-suppressive doses of d- and l-thyroxine in treatment of hypercholesterolemia
Abstract
In an attempt to compare the cholesterol-lowering effects of equivalent doses of D- and L-thyroxine, 10 euthyroid, hypercholesterolemic subjects were treated with graded doses of each medication in a cross-over design using thyrotropin suppression following thyrotropin-releasing hormone administration as the end-point. The mean thyrotropin-suppressive dose of D-thyroxine was 2.4 +/- 0.66 mg per day, which resulted in mean reductions of 10 percent in total plasma cholesterol, 10 percent in plasma low-density lipoprotein cholesterol, and 11 percent in plasma high-density lipoprotein cholesterol. The mean thyrotropin-suppressive dose of L-thyroxine was 135 +/- 46 micrograms per day, which resulted in mean reductions of 7 percent in total plasma cholesterol, 6 percent in plasma low-density lipoprotein cholesterol, and 14 percent in plasma high-density lipoprotein cholesterol. The reductions in total, low-density, and high-density cholesterol achieved with D-thyroxine were not significantly different from those achieved with L-thyroxine. Neither medication produced a significant increase in heart rate or ventricular ectopy as determined by Holter monitoring. These data do not support the belief that D-thyroxine has a preferential cholesterol-lowering effect in humans when compared with equivalent doses of L-thyroxine. In addition, both D- and L-thyroxine reduced plasma high-density lipoprotein cholesterol.
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At present, LT4 does not have a recognised role in dyslipidaemia management of euthyroid individuals.
“At present, LT4 does not have a recognised role in dyslipidaemia management of euthyroid individuals, however”
From Pharmacodynamic and Therapeutic Actions of Levothyroxine (2021) · cites this paper as [46]
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- Authors
- Bantle, J. P., Hunninghake, D. B., Frantz, I. D., Kuba, K., Mariash, C. N., & Oppenheimer, J. H.
- Corresponding author
- Bantle, John P.
- ORCID
- Mariash, Cary N.
- Venue
- The American Journal of Medicine
- Publisher
- Elsevier BV
- Published
- 1984-09
- Volume
- 77
- Issue
- 3
- Pages
- 475-481
- ISSN
- 0002-9343 (ISSN-L)
- OpenAlex
- W2086411615
- Cited by
- 24
- References
- 19
- Citations by year
- 2025: 1 · 2021: 2 · 2020: 1 · 2019: 2 · 2017: 1
- FWCI
- 1.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- NIH Clinical Center
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
- Keywords
- D-thyroxine, levothyroxine, hypercholesterolemia, cholesterol-lowering effect, TSH suppression, thyrotropin-releasing hormone stimulation, serum cholesterol, LDL cholesterol, HDL cholesterol, heart rate, ventricular ectopy
- MeSH terms
- Adult, Cholesterol, Dextrothyroxine, Dose-Response Relationship, Drug, Female, Heart Rate, Humans, Hypercholesterolemia, Lipoproteins, HDL, Cholesterol, HDL, Lipoproteins, LDL, Cholesterol, LDL, Male, Middle Aged, Thyrotropin, Thyroxine, Triglycerides
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