END‐ORGAN RESPONSES TO THYROXINE THERAPY IN SUBCLINICAL HYPOTHYROIDISM
Abstract
SUMMARY: We studied variables known to change with thyroid hormone status in 18 patients with subclinical hypothyroidism before and during treatment with thyroxine in a dose sufficient to restore the plasma TSH response to TRH to normal. There was an associated increase in both plasma total T4 and free T4 within the normal range but plasma total T3 and free T3 were unchanged. As a result of thyroxine treatment there was a small but significant increase (P < 0.05) in left ventricular ejection fraction (LVEF) with maximal exercise but no significant changes in LVEF at rest and moderate exercise, continuously monitored mean sleeping heart rate, day/night ratios of urinary sodium excretion, peripheral nerve conduction velocities, fasting serum triglycerides, total cholesterol (TC), high density lipoproteins (HDL) or TC/HDL ratios. On this evidence we do not consider that thyroxine replacement therapy is indicated in patients with subclinical hypothyroidism.
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Clinical scores may not be sufficiently sensitive to signal subtle changes in thyroid status.
“However, such clinical scores may not be sufficiently sensitive to signal subtle changes in thyroid status (69).”
From Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement (2014) · cites this paper as [69]
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- Authors
- BELL, G. M., TODD, W. T. A., FORFAR, J. C., MARTYN, C., WATHEN, C. G., GOW, S., RIEMERSMA, R., & TOFT, A. D.
- Affiliations
- Edinburgh Royal Infirmary (GB)
- Corresponding author
- TOFT, A. D.
- ORCID
- GOW, S.
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 1985-01
- Volume
- 22
- Issue
- 1
- Pages
- 83-89
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W2077688299
- Cited by
- 112
- References
- 33
- Citations by year
- 2021: 1 · 2019: 2 · 2018: 6 · 2017: 1 · 2016: 1 · 2015: 2 · 2014: 3 · 2013: 2 · 2012: 1
- FWCI
- 3.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- 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
- subclinical hypothyroidism, thyroxine replacement, levothyroxine, thyroid hormone status, left ventricular ejection fraction, exercise stress, sodium excretion, peripheral nerve conduction velocity, serum triglycerides, cholesterol, HDL cholesterol, total thyroxine, free thyroxine, total T3, free T3, TSH response to TRH
- MeSH terms
- Adult, Female, Heart, Humans, Hypothyroidism, Male, Middle Aged, Thyrotropin, Thyroxine, Triiodothyronine
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