Effect of Levothyroxine on Older Patients With Subclinical Hypothyroidism: A Systematic Review and Meta-Analysis
Open accessAbstract
Background: Subclinical hypothyroidism (SCH) is usually treated with levothyroxine, but there is controversy as to whether SCH should be treated, especially for older patients. The aim of the systematic review and meta-analysis was to evaluate whether levothyroxine has a beneficial or harmful effect on older patients with SCH. Methods: Databases including PubMed, Embase, Cochrane Library, Web of Science, Wanfang, Weipu and China National Knowledge Infrastructure were searched from inception until December 21, 2021. Subjects must be diagnosed with SCH, and older than or equal to 60 years of age. Interventions should be thyroid hormone therapy (e.g. levothyroxine). The literature was independently screened by 2 researchers. Statistical analysis was performed using RevMan5.3 software. Results: A total of 13 articles were included. Meta-analysis results showed that in older SCH patients, levothyroxine can significantly reduce cholesterol (TC) (p < 0.00001), triglyceride (TG) (p < 0.00001), low-density lipoprotein cholesterol (LDL-C) (p = 0.03) and apolipoprotein B (ApoB) (p < 0.00001). In addition, levothyroxine had no significant effect on bone mineral density, fatigue, hypothyroidism symptoms, quality of life, BMI, cognitive function, depression, blood pressure, etc. in older SCH patients, and also did not significantly increase the incidence of adverse events. Conclusions: Among older SCH patients, levothyroxine treatment may reduce TC, TG, LDL-C, and ApoB.
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The results for subclinical hypothyroidism are in accordance with a previous meta-analysis.
“These results are in accordance with a previous meta-analysis [33].”
From Effects of levothyroxine therapy on bone and mineral metabolism in hypothyroidism: a systematic review and meta-analysis (2025) · cites this paper as [33]
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BackgroundInfluential
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ResultExploring hypothyroidism’s effects on lipid profiles
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“Thus, systolic and diastolic heart function did not differ after treatment with levothyroxine compared with placebo in older adults with mild SCH. 26 On a different front, HypoT causes pericardial effusion through increased permeability of the epicardial vessels and decreased lymphatic drainage of albumin, resulting i…”
InfluentialLEVOTIROXINA NAS DISFUNÇÕES DA TIREOIDE
dos Santos, A. Q., Araújo, E. S., Alencar, E., Jurema, H. C., Santos, K. M., de Souza, R. D., de Araújo, R. G., & Campos, T. (2023) · Revista contemporânea · doi:10.56083/rcv3n12-271
- Authors
- Zhao, C., Wang, Y., Xiao, L., & Li, L.
- Affiliations
- Sichuan University (CN)
- Corresponding author
- Li, Lin
- Venue
- Frontiers in Endocrinology
- Publisher
- Frontiers Media SA
- Published
- 2022-07-14
- Volume
- 13
- Pages
- 913749-913749
- ISSN
- 1664-2392 (ISSN-L)
- PMC
- PMC9329610
- OpenAlex
- W4285386065
- Cited by
- 19
- References
- 45
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 3 · 2023: 9 · 2022: 1
- FWCI
- 0.57
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Endocrinology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Sichuan University (ZYGD18016)
- West China Hospital, Sichuan University (ZYGD18016, 1.3.5 project, 1.3.5)
- 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, levothyroxine, older adults, thyroid hormone replacement, cholesterol, triglycerides, LDL cholesterol, apolipoprotein B, bone mineral density, adverse events, quality of life
- MeSH terms
- Aged, Apolipoproteins B, Cholesterol, Humans, Hypothyroidism, Cholesterol, LDL, Quality of Life, Thyroxine, Triglycerides
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