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Cited by 49Thyroid Disorders and TreatmentsAdrenal Hormones and DisordersThyroid Cancer Diagnosis and Treatment

Single-Dose T3 Administration: Kinetics and Effects on Biochemical and Physiological Parameters

Open access
Jonklaas, Jacqueline, Burman, Kenneth D., Wang, Hong, Latham, Keith R.·2015·Therapeutic Drug Monitoring
DOI 10.1097/ftd.0000000000000113PMC PMC5167556
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Abstract

BACKGROUND: As changes in thyroid stimulating hormone (TSH), thyroid hormones, and vital signs after administration of a single dose of liothyronine have typically only been documented for 24 hours, we documented these parameters more than 96 hours. METHODS: Blood samples were obtained for 4 days after administration of 50-mcg liothyronine to 12 healthy euthyroid participants. Concentrations of total and free triiodothyronine, free and total thyroxine, and TSH were measured. Vital signs were documented. RESULTS: Triiodothyronine concentrations peaked at 2.5 hours after liothyronine administration. Heart rate (HR) increased by 5 hours after liothyronine administration, subsequently reaching a value higher than baseline (P = 0.009). Suppression of TSH concentrations began at 2 hours. The nadir TSH value at 12 hours was significantly different from baseline (P < 0.001) and remained lower than the baseline value for 2-3 days. CONCLUSIONS: A single dose of liothyronine has both short-term and long-term effects. There is clearly a different lag time between the serum concentrations of triiodothyronine and its effects on the heart and pituitary, respectively. The increase in serum triiodothyronine concentration occurred within hours and was then followed by an increase in HR. The increased HR was transient and was followed by a reduction in TSH concentration. The suppression of TSH was delayed but was more sustained. Thus, sustained TSH reduction beyond 24 hours was achieved by a single dose of liothyronine that produced only brief increases in serum triiodothyronine levels and transient increases in HR.

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  • After the T3 spike, T3 rapidly subsides after two distinct phases of linear elimination: a fast distribution phase with a half-life of about 2 hours and a slow elimination phase with a half-life of about 23 hours.

    “rapidly subsides after two distinct phases of linear elimination: a fast distribution phase with a half-life of ∼2 hours and a slow elimination phase with a half-life of ∼23 hours, supporting a two-compartment model”

    From Liothyronine and Desiccated Thyroid Extract in the Treatment of Hypothyroidism (2020) · cites this paper as [46]

    The Results report a 22-hour half-life calculated across the decline from 2.5 to 94 hours, broadly consistent with the claimed approximately 23-hour value. The Discussion acknowledges distribution into other compartments, but does not report a distinct 2-hour distribution half-life or two linear elimination phases. It instead says multiple release rates from the gut best explain the observed T3 profile; the two-compartment gut model it mentions is a model from another study. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Sustained serum T3 levels were not observed with other formulations prepared with microcrystalline cellulose and magnesium stearate (BCT303).

    “However, sustained serum T3 levels were not observed with other formulations prepared with microcrystalline cellulose and magnesium stearate (BCT303) (56).”

    From Emerging Therapies in Hypothyroidism (2024) · cites this paper as [56]

  • Oral administration of LT3-containing tablets is followed by a spike of T3 in the circulation that peaks around 2-3 hours.

    “The oral administration of LT3-containing tablets is followed by a spike of T3 in the circulation that peaks around 2–3 hours”

    From Liothyronine and Desiccated Thyroid Extract in the Treatment of Hypothyroidism (2020) · cites this paper as [46]

  • The pharmacodynamic action of T3 outlasts the period of increased plasma concentration of T3.

    “It has been observed that the pharmacodynamic action of T3 outlasts the period of increased plasma concentration of T3 32 .”

    From A review of the safety of triiodothyronine in combination with levothyroxine for the management of hypothyroidism (2024) · cites this paper as [32]

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Research works printed but not linked: 2

  1. [6]Watson ANDA study (data provided in FDA review of original ANDA).
  2. [16]Brunton L Chabner B Knollman B Goodman & Gilman’s The Pharmacological Basis of Therapeutics, Online edition Chapter 2: Pharmacokinetics, Steady State McGraw-Hill Companies

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Authors
Jonklaas, J., Burman, K. D., Wang, H., & Latham, K. R.
Affiliations
  • Georgetown University Medical Center (US)
  • MedStar Washington Hospital Center (US)
  • MedStar Health Research Institute (US)
Corresponding author
Jonklaas, Jacqueline
ORCID
Venue
Therapeutic Drug Monitoring
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2015-02
Volume
37
Issue
1
Pages
110-118
ISSN
0163-4356 (ISSN-L)
DOI
10.1097/ftd.0000000000000113
PMC
PMC5167556
OpenAlex
W2331609984
Cited by
49
References
20
Citations by year
2026: 5 · 2025: 6 · 2024: 4 · 2023: 7 · 2022: 6 · 2021: 4 · 2020: 5 · 2019: 7 · 2018: 1 · 2017: 1 · 2016: 3
FWCI
1.07
Type
journal article
Language
en
Open access
Locations
  • Therapeutic Drug Monitoring (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (UL1TR001409, UL1TR000101)
  • National Center for Research Resources (UL1RR031975)
  • National Center for Advancing Translational Sciences
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
Keywords
liothyronine, triiodothyronine, thyroxine, thyroid-stimulating hormone, TSH suppression, heart rate, euthyroid subjects, single-dose pharmacokinetics
MeSH terms
Adolescent, Adult, Body Temperature, Body Weight, Female, Half-Life, Heart Rate, Humans, Male, Thyrotropin, Thyroxine, Triiodothyronine, Young Adult

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