L-Thyroxine Therapy in Subclinical Hypothyroidism: A Double-Blind, Placebo-Controlled Trial

COOPER, DAVID S.; HALPERN, RACHELLE; WOOD, LAWRENCE C.; LEVIN, ANN A.; RIDGWAY, E. CHESTER

doi:10.7326/0003-4819-101-1-18

Cited by 423Thyroid Disorders and TreatmentsThyroid and Parathyroid SurgeryThyroid Cancer Diagnosis and Treatment

L-Thyroxine Therapy in Subclinical Hypothyroidism: A Double-Blind, Placebo-Controlled Trial

COOPER, DAVID S., HALPERN, RACHELLE, WOOD, LAWRENCE C., LEVIN, ANN A., RIDGWAY, E. CHESTER·1984·Annals of Internal Medicine

DOI 10.7326/0003-4819-101-1-18

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Abstract

The indications for treating patients with subclinical hypothyroidism (normal serum thyroxine and free thyroxine levels, but elevated serum thyrotrophin levels) are poorly defined. In this study, 33 patients with subclinical hypothyroidism were randomly assigned in a double-blind manner to receive placebo or L-thyroxine therapy and were followed for 1 year with thyroid function tests, serum lipid measurements, basal metabolic rate and systolic time interval determinations, and a questionnaire on hypothyroid symptoms. The placebo group showed no changes in thyroid function or peripheral indices of thyroid hormone action. In the thyroxine-treated group, serum lipids and the mean systolic time interval did not change, but the systolic time intervals became normal in the 5 patients with the most abnormal baseline values. Symptoms improved in 8 of 14 patients receiving thyroxine and in 3 of 12 patients receiving placebo (p less than 0.05). L-Thyroxine therapy may be useful for patients with subclinical hypothyroidism with abnormal myocardial contractility or symptoms consistent with mild hypothyroidism, or both.

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RCTs have demonstrated that LT4 replacement therapy affects myocardial function, particularly diastolic function, and over time the brachial artery intimal thickness.
“Similarly, RCTs have demonstrated that LT4 replacement therapy affects myocardial function (87) and particularly diastolic function (88-92), and, over time, the brachial artery intimal thickness (89,93).”
From Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement (2014) · cites this paper as [87]

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Authors: COOPER, D. S., HALPERN, R., WOOD, L. C., LEVIN, A. A., & RIDGWAY, E. C.
Affiliations: Harvard University (US)
Boston, Massachusetts
Corresponding author: COOPER, DAVID S.
ORCID: COOPER, DAVID S.
Venue: Annals of Internal Medicine
Publisher: American College of Physicians
Published: 1984-07-01
Volume: 101
Issue: 1
Pages: 18-24
ISSN: 0003-4819 (ISSN-L)
1539-3704
DOI: 10.7326/0003-4819-101-1-18
OpenAlex: W1976274614
Cited by: 423
References: 27
Citations by year: 2026: 1 · 2023: 2 · 2022: 1 · 2021: 6 · 2020: 2 · 2019: 5 · 2018: 4 · 2017: 11 · 2016: 8 · 2015: 5 · 2014: 9 · 2013: 19 · 2012: 17
FWCI: 9.48
Type: journal article
Language: en
Open access: closed
Licence: www.acpjournals.org/journal/aim/text-and-data-mining (tdm)
Locations: Annals of Internal Medicine (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 › Thyroid Cancer Diagnosis and Treatment
Keywords: subclinical hypothyroidism, L-thyroxine therapy, thyroid hormone replacement, thyroid-stimulating hormone, serum lipids, basal metabolic rate, systolic time intervals, cardiac contractility
MeSH terms: Adult, Aged, Double-Blind Method, Drug Evaluation, Female, Humans, Hypothyroidism, Male, Middle Aged, Myocardial Contraction, Prolactin, Random Allocation, Thyrotropin, Thyrotropin-Releasing Hormone, Thyroxine

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L-Thyroxine Therapy in Subclinical Hypothyroidism: A Double-Blind, Placebo-Controlled Trial

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