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L-Thyroxine Therapy in Subclinical Hypothyroidism: A Double-Blind, Placebo-Controlled Trial
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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“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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Metadata
- 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
- 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
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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