Effects of levothyroxine: A Synthesis of Findings from 7 Studies

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Original Abstract of the Article

Main Research Findings

Hypothyroidism is a common endocrine disease that can lead to health problems and even death, especially in older adults. Long-term treatment with levothyroxine can have several side effects. 7 Herbal medicine may help regulate thyroid hormones and prevent side effects. 7

A study involving older adults with subclinical hypothyroidism found no evidence that levothyroxine treatment affects bone health over a one-year period. 6

Liothyronine therapy may have metabolic effects compared to levothyroxine therapy. Liothyronine is a more metabolically active form of thyroid hormone than levothyroxine, and it might help with weight loss and lower cholesterol levels. 3

In patients with thyroid cancer, adding metformin to the medication regimen did not help compensate for a 33% reduction in levothyroxine dose. 5

Preliminary research suggests that taking levothyroxine at bedtime might decrease TSH levels and increase free thyroxine and total triiodothyronine levels compared to taking it in the morning. However, larger studies are needed to confirm this finding. 2

Levothyroxine treatment can cause oxidative stress, but using physiological modulators (PMs) may make treatment more tolerable. 4 One study showed that using a formula containing oligomeric proanthocyanidins (OPA) may reduce the incidence of side effects during the initial phase of levothyroxine treatment. 4

In patients with hypothyroidism, partially substituting triiodothyronine for thyroxine may improve mood and neuropsychological function, suggesting a specific effect of triiodothyronine normally secreted by the thyroid gland. 1

Benefits and Risks

Benefit Summary

Levothyroxine is an effective medication for hypothyroidism, and with proper dosage, it can help restore thyroid hormone balance and improve metabolism. 7

Some research suggests that combining liothyronine with levothyroxine may improve mood and neuropsychological function. 1

Risk Summary

Long-term use of levothyroxine may increase the risk of osteoporosis, cardiovascular disease, and other health problems. 6 , 5

Levothyroxine can cause oxidative stress and lead to side effects like palpitations, sweating, anxiety, and headaches. 4

Comparison of Studies

Similarities

All studies investigated the effects of levothyroxine, a medication used to treat hypothyroidism.

Differences

The studies varied in their target populations, treatment methods, and outcome measures. For example, one study assessed the impact of levothyroxine on bone density in older adults with subclinical hypothyroidism, while another studied the effect of reducing levothyroxine dose in patients with thyroid cancer.

Consistency and Contradictions

Some studies showed no effect of levothyroxine on bone density, while others suggested a possible increased risk of osteoporosis. 6 , 5

Research on the combined use of levothyroxine and liothyronine yielded varying results, with some suggesting benefits in mood and neuropsychological function, while others indicated that levothyroxine alone may be sufficient. 1

Practical Implications

It's essential to choose the right dosage and administration method for levothyroxine, tailored to each individual's needs. Since levothyroxine can have side effects, regular check-ups with a doctor are important.

Limitations of Current Research

Research on levothyroxine is still ongoing and not entirely comprehensive. Further investigation is needed, particularly regarding long-term effects and efficacy across different patient populations.

Future Research Directions

More research is required on the combination of levothyroxine with other treatments, including herbal medicine and liothyronine. In-depth studies on the effects of levothyroxine in specific patient groups, such as the elderly and those with thyroid cancer, are also necessary.

Conclusion

Levothyroxine is an effective treatment for hypothyroidism, but further research on its side effects and long-term impact is needed. It is important to choose the appropriate treatment plan in consultation with your doctor.

Literature analysis of 7 papers
Positive Content
5
Neutral Content
1
Negative Content
1
Article Type
6
0
1
0
7
1.

Effects of thyroxine as compared with thyroxine plus triiodothyronine in patients with hypothyroidism.

Author: BuneviciusR, KazanaviciusG, ZalinkeviciusR, PrangeA J

Improved mood and neuropsychological function

In patients with hypothyroidism, partial substitution of triiodothyronine for thyroxine may improve mood and neuropsychological function. In a study of 33 patients with hypothyroidism, patients had lower serum free and total thyroxine concentrations and higher serum total triiodothyronine concentrations after treatment with thyroxine plus triiodothyronine than after thyroxine alone, whereas the serum thyrotropin concentrations were similar after both treatments.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

Effects of evening vs morning levothyroxine intake: a randomized double-blind crossover trial.

Author: BolkNienke, VisserTheo J, NijmanJudy, JongsteIneke J, TijssenJan G P, BerghoutArie

Improved thyroid function

This study highlights the need for further research to determine the optimal time for levothyroxine intake in patients with hypothyroidism. The authors emphasize the lack of large randomized trials and suggest that bedtime intake may be more effective than morning intake.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

3.

Metabolic effects of liothyronine therapy in hypothyroidism: a randomized, double-blind, crossover trial of liothyronine versus levothyroxine.

Author: CeliFrancesco S, ZemskovaMarina, LindermanJoyce D, SmithSheila, DrinkardBart, SachdevVandana, SkarulisMonica C, KozloskyMerel, CsakoGyorgy, CostelloRene, PucinoFrank

Thyroid hormone action

Levothyroxine (L-T(4)) alone may not restore a euthyroid state in all tissues, as observed in rodents. Further research is needed to assess the effectiveness of combination L-T(4)/L-T(3) therapy on thyroid hormone action.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, N.I.H., IntramuralFunding provided by the NIH for research projects within the NIH.

Language : English

4.

Activity of some physiological modulators in reducing the side effects of levothyroxine in patients suffering from primary hypothyroidism.

Author: CornelliU, BelcaroG, LeddaA, FeragalliB

Hypothyroidism treatment
Daily discomfort
Oxidative stress

The use of a formula containing OPA with other PMs may limit the incidence of the side effects that occur during the initial phase of L-T4 treatment in hypothyroidism.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

5.

Effects of short-term metformin therapy associated with levothyroxine dose decrement on TSH and thyroid hormone levels in patients with thyroid cancer.

Author: MousaviZ, DourandishL, RokniH, SadeghiR, Rasoul ZakaviS

Subclinical hyperthyroidism

A single-blind randomized controlled trial of 50 non-diabetic patients with DTC found that adding 500 mg of metformin to the drug regimen was not useful to compensate for a 33% reduction in levothyroxine dose.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

Skeletal Effects of Levothyroxine for Subclinical Hypothyroidism in Older Adults: A TRUST Randomized Trial Nested Study.

Author: Gonzalez RodriguezElena, StuberMirah, Del GiovaneCinzia, FellerMartin, ColletTinh-Hai, LöweAxel L, BlumManuel R, van VlietNicolien A, van HeemstDiana, KearneyPatricia M, GusseklooJacobijn, MooijaartSimon, WestendorpRudi G J, StottDavid J, AeberliDaniel, BauerDouglas C, HansDidier, RodondiNicolas

Bone loss
Thyroid dysfunction

This study found that levothyroxine had no effect on bone health in older adults with subclinical hypothyroidism over 1 year.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Achievements in Hypothyroidism Treatment with Herbal Medicine: A Systematic Review of Randomized Controlled Trials.

Author: JavidiNajmeh, KhorasaniZahra Mazloum, SalariRoshanak, NiroumandShabnam, YousefiMahdi

Hypothyroidism treatment

Hypothyroidism is a common condition that can cause health problems, especially in older adults. While medications are used to treat hypothyroidism, they can have side effects. Herbal remedies are being explored as a potential treatment for hypothyroidism that can regulate thyroid hormones and reduce side effects.

Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

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