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Combined thyroxine and triiodothyronine therapy is not more effective than thyroxine alone in patients with hypothyroidism (II)
The background of the study. This study provides
more information on the question of whether patients with hypothyroidism
benefit from therapy with thyroxine (T4) and triiodothyronine (T3)
therapy, as compared with T4 alone.
How the study was done. The subjects in this study were 26 women with hypothyroidism. All had been taking 100 µg of T4 daily and had normal serum thyrotropin (TSH) concentrations for at least one year. The women were randomly assigned to take 100 µg of T4 alone or 75 µg of T4 plus 5 µg of T3 for eight weeks, and then the opposite combination for eight weeks. All were then given 87.5 µg of T4 plus 7.5 µg of T3 for eight weeks.
The women were studied at the end of the three periods. The primary end points were the woman’s preference, as reported at the end of the study, and the results of questionnaires about mood, cognitive function, quality of life, and symptoms of hypothyroidism and measurements of serum TSH at the end of each period.
The results of the study. At study end, 12 women (46 percent) preferred the regimen of 75 µg T4 plus 5 µg T3, 6 (23 percent) the regimen of 87.5 µg T4 plus 7.5 µg T3, and 2 (8 percent) the T4 regimen; 6 (23 percent) had no preference. The scores on all the questionnaires were very similar at the end of each treatment period.
The values for body-mass index were similar at the end of each treatment period, as were the mean serum TSH and free T4 concentrations.
The conclusions of the study. In a crossover trial of T4 and two T4-plus-T3 regimens in women with hypothyroidism, the regimen of 75 µg T4 plus 5 µg T3 (15:1) was preferred by nearly 50 percent, but there were few differences in the scores on many tests at the end of the three treatment periods.
The original article. Escobar-Morreale HF, Botella-Carretero
JI, Gomez-Bueno M, Galan JM, Barrios V, Sancho J. Thyroid hormone
replacement therapy in primary hypothyroidism: a randomized trial
comparing L-thyroxine plus liothyronine with L-thyroxine alone.
Ann Intern Med 2005;142:412-24.
Next Article: Combined thyroxine
and triiodothyronine therapy is not more effective than thyroxine
alone in patients with hypothyroidism (III)
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| Thyroid Digest Index | | | July 2005 Thyroid Digest |
