Paper
Desiccated thyroid extract compared with levothyroxine in the treatment of hypothyroidism: a randomized, double-blind, crossover study.
Published Mar 28, 2013 · T. Hoang, C. Olsen, V. Mai
The Journal of clinical endocrinology and metabolism
130
Citations
8
Influential Citations
Abstract
CONTEXT Patients previously treated with desiccated thyroid extract (DTE), when being switched to levothyroxine (L-T₄), occasionally did not feel as well despite adequate dosing based on serum TSH levels. OBJECTIVE Our objective was to investigate the effectiveness of DTE compared with L-T₄ in hypothyroid patients. DESIGN AND SETTING We conducted a randomized, double-blind, crossover study at a tertiary care center. PATIENTS Patients (n = 70, age 18-65 years) diagnosed with primary hypothyroidism on a stable dose of L-T₄ for 6 months were included in the study. INTERVENTION Patients were randomized to either DTE or L-T₄ for 16 weeks and then crossed over for the same duration. OUTCOME MEASURES Biochemical and neurocognitive tests at baseline and at the end of each treatment period were evaluated. RESULTS There were no differences in symptoms and neurocognitive measurements between the 2 therapies. Patients lost 3 lb on DTE treatment (172.9 ± 36.4 lb vs 175.7 ± 37.7 lb, P < .001). At the end of the study, 34 patients (48.6%) preferred DTE, 13 (18.6%) preferred L-T₄, and 23 (32.9%) had no preference. In the subgroup analyses, those patients who preferred DTE lost 4 lb during the DTE treatment, and their subjective symptoms were significantly better while taking DTE as measured by the general health questionnaire-12 and thyroid symptom questionnaire (P < .001 for both). Five variables were predictors of preference for DTE. CONCLUSION DTE therapy did not result in a significant improvement in quality of life; however, DTE caused modest weight loss and nearly half (48.6%) of the study patients expressed preference for DTE over L-T₄. DTE therapy may be relevant for some hypothyroid patients.
RCT
Rigorous Journal
Highly CitedDTE therapy did not significantly improve quality of life, but caused modest weight loss and nearly half (48.6%) of study patients preferred it over levothyroxine, suggesting it may be relevant for some hypothyroid patients.
Full text analysis coming soon...