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Cited by 165Thyroid Disorders and TreatmentsThyroid and Parathyroid SurgeryThyroid Cancer Diagnosis and Treatment

The DOI matches its Crossref record; 29 of the 31 references it cites were found in a registry or an index.

Small Changes in Thyroxine Dosage Do Not Produce Measurable Changes in Hypothyroid Symptoms, Well-Being, or Quality of Life: Results of a Double-Blind, Randomized Clinical Trial

Walsh, John P., Ward, Lynley C., Burke, Valerie, Bhagat, Chotoo I., Shiels, Lauren, Henley, David, Gillett, Melissa J., Gilbert, Rhonda, Tanner, Melissa, Stuckey, Bronwyn G. A.·2006·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jc.2006-0099
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Abstract

Context: In patients with primary hypothyroidism, anecdotal evidence suggests that well-being is optimized by fine adjustment of T4 dosage, aiming for a serum TSH concentration in the lower reference range. This has not been tested in a clinical trial. Objective: Our objective was to test whether adjustment of T4 dosage aiming for a serum TSH concentration less than 2 mU/liter improves well-being compared with a serum TSH concentration in the upper reference range. Design: We conducted a double-blind, randomized clinical trial with a crossover design. Participants: Fifty-six subjects (52 females) with primary hypothyroidism taking T4 (≥100 μg/d) with baseline serum TSH 0.1–4.8 mU/liter participated. Interventions: Each subject received three T4 doses (low, middle, and high in 25-μg increments) in random order. Outcome Measures: Outcome measures included visual analog scales assessing well-being (the primary endpoint) and hypothyroid symptoms, quality of life instruments (General Health Questionnaire 28, Short Form 36, and Thyroid Symptom Questionnaire), cognitive function tests, and treatment preference. Results: Mean (± sem) serum TSH concentrations were 2.8 ± 0.4, 1.0 ± 0.2, and 0.3 ± 0.1 mU/liter for the three treatments. There were no significant treatment effects on any of the instruments assessing well-being, symptoms, quality of life, or cognitive function and no significant treatment preference. Conclusions: Small changes in T4 dosage do not produce measurable changes in hypothyroid symptoms, well-being, or quality of life, despite the expected changes in serum TSH and markers of thyroid hormone action. These data do not support the suggestion that the target TSH range for the treatment of primary hypothyroidism should differ from the general laboratory range.

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Metadata

Authors
Walsh, J. P., Ward, L. C., Burke, V., Bhagat, C. I., Shiels, L., Henley, D., Gillett, M. J., Gilbert, R., Tanner, M., & Stuckey, B. G. A.
Affiliations
  • The University of Western Australia (AU)
  • Departments of Endocrinology and Diabetes (J.P.W., L.C.W., B.G.A.S., D.H., M.J.G.) Nedlands, Western Australia 6009
  • Pathwest Laboratory Medicine (AU)
  • Psychiatry and Behavioural Science (L.S.), Nedlands, Western Australia 6009
Corresponding author
Walsh, John P.
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2006-07-01
Volume
91
Issue
7
Pages
2624-2630
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jc.2006-0099
OpenAlex
W2085495215
Cited by
164
References
31
Citations by year
2026: 6 · 2025: 6 · 2024: 7 · 2023: 7 · 2022: 15 · 2021: 11 · 2020: 13 · 2019: 9 · 2018: 8 · 2017: 11 · 2016: 9 · 2015: 4 · 2014: 9 · 2013: 12 · 2012: 8
FWCI
4.88
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
  • UWA Profiles and Research Repository (UWA) (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
primary hypothyroidism, levothyroxine dosage, serum TSH, well-being, quality of life, cognitive function, treatment preferences, thyroid hormone replacement
MeSH terms
Adult, Cognition, Dose-Response Relationship, Drug, Double-Blind Method, Female, Humans, Hypothyroidism, Male, Middle Aged, Quality of Life, Surveys and Questionnaires, Thyrotropin, Thyroxine, Triiodothyronine, Treatment Outcome

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