In subgroup analysis, two included studies examined the relationship between mental improvement and causes of hypothyroidism, autoimmune, and nonautoimmune hypothyroidism, respectively. T4 alone suggested significantly higher total T4 (autoimmune and nonautoimmune thyroid, WMD: 4.5, 3.7; 95 CI:, respectively and significantly decreased thyroid-stimulating hormone (WMD: -0.05; 95 CI: -0.09 to -0.01).
The adequacy of thyroxine alone versus thyroxine plus triiodothyronine to treat hypothyroidism has yielded conflicting results. Therefore, we conducted a systematic review of all included published, randomized controlled trials to evaluate the effects of thyroxine alone or thyroxine plus triiodothyronine replacement therapy for hypothyroidism.
Approximately 80 percent of a dose of T4 is absorbed and, because the plasma half-life of T4 is long (seven days once-daily treatment results in nearly constant serum thyroxine (T4) and triiodothyronine (T3) concentrations when a steady state is reached 2.
Statistically significant improvement occurred in pairs correctly recalled in the Digit Symbol Test for T4 plus T3 replacement (WMD: -1.60; 95 CI: -2.97 to -0.23) for nonautoimmune thyroid. In conclusion, on the basis of data from recent studies, we conclude that combined T4 and T3 treatment does not improve well-being, cognitive function, or quality of.
We electronically searched Medline, Embase, the Cochrane Library, and China National Infrastructure. We also manually searched the Chinese Journal of Isotopes, Radiologia pratica, and the Chinese Journal of Endocrinology and Metabolism.
T4 alone may be beneficial in improving psychological or physical well-being. According to the current evidence, T4 alone replacement may remain the drug of choice for hypothyroid patients.
The approach to therapy of patients with subclinical, congenital, and central hypothyroidism is discussed separately. (See "Subclinical hypothyroidism" and "Treatment and prognosis of congenital hypothyroidism" and "Central hypothyroidism".) STANDARD REPLACEMENT THERAPY The treatment of choice for correction of hypothyroidism is synthetic T4 (levothyroxine).
A total of 10 randomized, double-blind trials (six crossovers, four parallel trials) were identified. Pooled analyses were suggestive of a statistically significant increase of free and total triiodothyronine, significant decrease of serum-free and total thyroxine in patients treated with thyroxine plus triiodothyronine, weighted mean difference (WMD) 0.03, -31.25, 2.19, 3.00; 95 confidence interval (CI) -0.14.
JAMA The Journal of the American Medical Association (Impact Factor: 35.29). 04/2004; 291(12 1445; author reply 1445. DOI: 10.1001/jama.-a).
INTRODUCTION In most patients, hypothyroidism is a permanent condition requiring lifelong treatment. Therapy consists of thyroid hormone replacement unless the hypothyroidism is transient (as after painless thyroiditis or subacute thyroiditis) or reversible (due to a drug that can be discontinued).
Thyroxin alone indicated significant benefits for psychological or physical well-being in terms of the General Health Questionnaire-28 (WMD: -2.90; 95 CI: -3.18 to -2.63 general health (WMD: -0.38; 95 CI: -0.71 to -0.05 physical component summary (WMD: 0.7; 95 CI: and mental component summary (WMD: 0.58; 95 CI: physical functioning (WMD: 1.60; 95 CI: role-physical.
Letter from JAMA Synthetic Thyroxine vs Dessicated Thyroid. 2004;291(12 1445. doi:10.1001/jama.-a. Text Size:. Published online).
Synthetic Thyroxine vs Dessicated Thyroid. To the Editor: Dr Clyde and colleagues1 concluded that treatment of primary hypothyroidism with. 2004;291:1445.
Oct 8, 2015.
A comparison of thyroxine and desiccated thyroid in patients with primary. comparison of the two forms of treatment i.e. natural -v- synthetic thyroxine only. Thyroid, 14(4 247- 248, 2004; Kosowicz, J., Horst-Sikorska, W., Lacka, K., et al).
JAMA. 2004 Mar 24;291(12 1445; author reply 1445. Synthetic thyroxine vs dessicated thyroid. Lichten EM. Comment on JAMA. 2003 Dec 10;290(22 2952-8).
However, T4 plus T3 replacement improved cognitive performance (WMD: -0.49; 95 CI: -0.90 to -0.08). No significant statistical differences were found in biochemical variables, mood states clinical variables, adverse effects, and drop-out.
Synthetic thyroxine vs dessicated thyroid. 2004Mar. Synthetic thyroxine vs dessicated thyroid. JAMA. JAMA 2004 Mar;291(12 1445; author reply 1445).