Effects of Altering Levothyroxine Dose on Energy Expenditure and Body Composition in Subjects Treated With LT4

The Journal of Clinical Endocrinology and Metabolism
Mary H SamuelsKathryn G Schuff

Abstract

It is unclear whether variations in thyroid status within or near the reference range affect energy expenditure, body mass, or body composition. 138 subjects treated with levothyroxine (LT4) for hypothyroidism with normal TSH levels underwent measurement of total, resting, and physical activity energy expenditure; thermic effect of food; substrate oxidation; dietary intake; and body composition. They were assigned to receive an unchanged, higher, or lower LT4 dose in randomized, double-blind fashion, targeting one of three TSH ranges (0.34 to 2.50, 2.51 to 5.60, or 5.61 to 12.0 mU/L). The doses were adjusted every 6 weeks to achieve target TSH levels. Baseline measures were reassessed at 6 months. At study end, the mean LT4 doses and TSH levels were 1.50 ± 0.07, 1.32 ± 0.07, and 0.78 ± 0.08 µg/kg (P < 0.001) and 1.85 ± 0.25, 3.93 ± 0.38, and 9.49 ± 0.80 mU/L (P < 0.001), respectively, in the three arms. No substantial metabolic differences in outcome were found among the three arms, although direct correlations were observed between decreases in thyroid status and decreases in resting energy expenditure for all subjects. The subjects could not ascertain how their LT4 dose had been adjusted but the preferred LT4 dose they percei...Continue Reading

Associated Clinical Trials

Nov 30, 2007·Mary Samuels, Mary Samuels

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Citations

Sep 25, 2018·The Journal of Clinical Endocrinology and Metabolism·Dorina Ylli, Leonard Wartofsky
Jul 3, 2019·The Journal of Clinical Endocrinology and Metabolism·Chiara MelePaolo Marzullo
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Jul 10, 2019·Journal of the Endocrine Society·Sahzene YavuzFrancesco S Celi
Jul 10, 2019·JAMA : the Journal of the American Medical Association·Bernadette BiondiDavid S Cooper
Oct 28, 2020·The Journal of Clinical Endocrinology and Metabolism·Christine N HuynhFrancesco S Celi
Feb 4, 2021·Endocrine·Johan P de GraafUNKNOWN Research and Science Work Package of Endo-ERN
Sep 21, 2021·Endocrine Reviews·Jacqueline Jonklaas

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