TIMING OF LEVOTHYROXINE IN THE TREATMENT OF PRIMARY HYPOTHYROIDISM
AACE ePoster Library. Mansour A. 05/13/15; 97808; 1059
Prof. Dr. Abbas Mansour
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Abstract
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Background: In patients with hypothyroidism a proper timing of levothyroxine administration could have a beneficial effect on the early obtaining euthyroid state. This approach to treatment was based on the fact that thyrotropin (TSH) is one of the biological substances that is subjected to circadian rhythm. This study aimed at investigating the best time for levothyroxine administration to patients with primary hypothyroidism that can achieve earlier normalization of TSH and free thyroxine (FT 4).
Patients and Methods: From November 2012 to July 2013 one hundred and eight patients with primary hypothyroidism were enrolled in this prospective, randomized study from Al-Faiha Diabetes Endocrine and Metabolism Center in Basrah (FDEMC), Southern Iraq. Patients were divided into two groups; the first group (morning group), were instructed to take levothyroxine one hour before breakfast. The second group (evening group), patients took the dose of levothyroxine at bedtime, 2 hours after the last meal. The blood pressure, body mass index, TSH, FT 4, lipid profile, was measured before starting the study, and of each month over three months (the study period).
Results: Eighty-two patients had completed the study. The mean difference of reduction in TSH from baseline for the two groups was compared (11.3±22.5 mIU/l for the morning group vs. 13.6±22.2 mIU/l for evening group). Although, it was higher in the evening group, it was not statistically significantly different from that of the morning group (P=0. 63, df =80, 95% CI: -12.17- 7.5). Comparing the difference between the increase in FT 4 for the morning and that of the evening group (7.6+6 pmol/l for morning vs. 5.7+4.9 pmol/l for evening) pmol/l revealed no significant differences between the two (P=0. 12, df =80, 95% CI: - 0.5-4.3).
Conclusions: We concluded that there was no difference between the morning and evening levothyroxine intake in regards to earlier normalization of TSH and FT 4.
Keywords: levothyroxine, Hypothyroidism, primary.
Patients and Methods: From November 2012 to July 2013 one hundred and eight patients with primary hypothyroidism were enrolled in this prospective, randomized study from Al-Faiha Diabetes Endocrine and Metabolism Center in Basrah (FDEMC), Southern Iraq. Patients were divided into two groups; the first group (morning group), were instructed to take levothyroxine one hour before breakfast. The second group (evening group), patients took the dose of levothyroxine at bedtime, 2 hours after the last meal. The blood pressure, body mass index, TSH, FT 4, lipid profile, was measured before starting the study, and of each month over three months (the study period).
Results: Eighty-two patients had completed the study. The mean difference of reduction in TSH from baseline for the two groups was compared (11.3±22.5 mIU/l for the morning group vs. 13.6±22.2 mIU/l for evening group). Although, it was higher in the evening group, it was not statistically significantly different from that of the morning group (P=0. 63, df =80, 95% CI: -12.17- 7.5). Comparing the difference between the increase in FT 4 for the morning and that of the evening group (7.6+6 pmol/l for morning vs. 5.7+4.9 pmol/l for evening) pmol/l revealed no significant differences between the two (P=0. 12, df =80, 95% CI: - 0.5-4.3).
Conclusions: We concluded that there was no difference between the morning and evening levothyroxine intake in regards to earlier normalization of TSH and FT 4.
Keywords: levothyroxine, Hypothyroidism, primary.
Background: In patients with hypothyroidism a proper timing of levothyroxine administration could have a beneficial effect on the early obtaining euthyroid state. This approach to treatment was based on the fact that thyrotropin (TSH) is one of the biological substances that is subjected to circadian rhythm. This study aimed at investigating the best time for levothyroxine administration to patients with primary hypothyroidism that can achieve earlier normalization of TSH and free thyroxine (FT 4).
Patients and Methods: From November 2012 to July 2013 one hundred and eight patients with primary hypothyroidism were enrolled in this prospective, randomized study from Al-Faiha Diabetes Endocrine and Metabolism Center in Basrah (FDEMC), Southern Iraq. Patients were divided into two groups; the first group (morning group), were instructed to take levothyroxine one hour before breakfast. The second group (evening group), patients took the dose of levothyroxine at bedtime, 2 hours after the last meal. The blood pressure, body mass index, TSH, FT 4, lipid profile, was measured before starting the study, and of each month over three months (the study period).
Results: Eighty-two patients had completed the study. The mean difference of reduction in TSH from baseline for the two groups was compared (11.3±22.5 mIU/l for the morning group vs. 13.6±22.2 mIU/l for evening group). Although, it was higher in the evening group, it was not statistically significantly different from that of the morning group (P=0. 63, df =80, 95% CI: -12.17- 7.5). Comparing the difference between the increase in FT 4 for the morning and that of the evening group (7.6+6 pmol/l for morning vs. 5.7+4.9 pmol/l for evening) pmol/l revealed no significant differences between the two (P=0. 12, df =80, 95% CI: - 0.5-4.3).
Conclusions: We concluded that there was no difference between the morning and evening levothyroxine intake in regards to earlier normalization of TSH and FT 4.
Keywords: levothyroxine, Hypothyroidism, primary.
Patients and Methods: From November 2012 to July 2013 one hundred and eight patients with primary hypothyroidism were enrolled in this prospective, randomized study from Al-Faiha Diabetes Endocrine and Metabolism Center in Basrah (FDEMC), Southern Iraq. Patients were divided into two groups; the first group (morning group), were instructed to take levothyroxine one hour before breakfast. The second group (evening group), patients took the dose of levothyroxine at bedtime, 2 hours after the last meal. The blood pressure, body mass index, TSH, FT 4, lipid profile, was measured before starting the study, and of each month over three months (the study period).
Results: Eighty-two patients had completed the study. The mean difference of reduction in TSH from baseline for the two groups was compared (11.3±22.5 mIU/l for the morning group vs. 13.6±22.2 mIU/l for evening group). Although, it was higher in the evening group, it was not statistically significantly different from that of the morning group (P=0. 63, df =80, 95% CI: -12.17- 7.5). Comparing the difference between the increase in FT 4 for the morning and that of the evening group (7.6+6 pmol/l for morning vs. 5.7+4.9 pmol/l for evening) pmol/l revealed no significant differences between the two (P=0. 12, df =80, 95% CI: - 0.5-4.3).
Conclusions: We concluded that there was no difference between the morning and evening levothyroxine intake in regards to earlier normalization of TSH and FT 4.
Keywords: levothyroxine, Hypothyroidism, primary.
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