October 19, 2015 Van Meter Awarded to Takashi Yoshimura, PhD Monday, October 19, 2015 1:15 pm ET (embargoed) The American Thyroid Association (ATA) will present Takashi Read More December 23, 2014 From Mayo Clinic Some medical discoveries truly stand the test of time.
We measured their weight on SECA scales (Hamburg, Germany). We measured cognitive functioning with logical memory, verbal paired associates, visual reproduction, and digit span tests from the revised Weschler memory scale.
No controls were ineligible and all completed the study. The local ethical committee approved the study and we obtained informed consent from all participants. Study protocol The study was a randomised double blind placebo controlled crossover trial.
Correspondence to: ollock Abstract Objectives: To determine whether thyroxine treatment is effective in patients with symptoms of hypothyroidism but with thyroid function tests within the reference range, and to investigate the effect of thyroxine treatment on psychological and physical wellbeing in healthy participants.
Treating underactive thyroid An underactive thyroid (hypothyroidism) is usually treated by taking daily hormone replacement tablets called levothyroxine. Levothyroxine replaces the thyroxine hormone, which your thyroid doesn't make enough of. You'll initially have regular blood tests until the correct dose of levothyroxine is reached.
The diagnosis is suggested by a low fT4 and features of pituitary disorder. In subclinical hypothyroidism the TSH is elevated (usually to 5-10 mIU/L) but the fT4 is normal. The typical symptoms of hypothyroidism are often absent.
We recruited patients either by referral from their general practitioner or hospital clinician, or through an article, published in a local newspaper, which described the trial and asked for volunteers. Controls were healthy volunteers recruited by personal contact with the investigators.
At the start of treatment a patient does not need measurement of their TSH until they have been on their predicted dose of thyroxine for 4-6 weeks (unless symptoms of thyrotoxicosis dictate otherwise).
Serum concentrations of free thyroxine increased and those of thyroid stimulating hormone decreased in patients and controls while they were taking thyroxine, confirming compliance with treatment. Although serum concentrations of free triiodothyronine increased in patients and controls taking thyroxine, the difference between the response to placebo and to thyroxine was significant only in the controls.
See Serum thyroid-stimulating hormone concentration and morbidity from cardiovascular disease and fractures in patients on long-term thyroxine therapy J Clin Endocrinol Metab. 2010 Jan;95(1 186-93. Is the dose of thyroxine based on body weight?
All participants were assessed physiologically and psychologically at baseline and on completion of each phase. Main outcome measures: Thyroid function tests, measures of cognitive function and of psychological and physical wellbeing.
Cholesterol was measured on a multichannel discrete analyser (Olympus Diagnostica, Hamburg, Germany) using a cholesterol oxidase method (Randox Laboratories Ltd, Co. Antrim, UK). Interassay coefficients of variation were 15 for thyroid stimulating hormone, 9 for free thyroxine, 8.5 for free triiodothyronine, 6 for prolactin, and 2 for cholesterol.
If the patient discovers they have missed one (or more) doses they can take the missed doses in conjunction with their usual dose over the next few days. The absorption of thyroxine may be reduced by cholestyramine, colestipol, aluminium hydroxide, ferrous sulfate and possibly fibre.
4 To investigate this further, we conducted a double blind placebo controlled crossover trial of thyroxine in patients who had symptoms of hypothyroidism but whose thyroid function tests were within the reference range.
The cause of primary hypothyroidism in an adult will usually be determined from a history of thyroidectomy or radiotherapy or finding high titres of antithyroid antibodies (thyroid peroxidase, antimicrosomal or antithyroglobulin antibodies).
Patients with smaller thyroid cancers who likely have very low risks of disease recurrence may find recommended levels of TSH close to the lower limit of normal, but not frankly suppressed.
There is no proven benefit in adding liothyronine to the treatment of patients who have persistent symptoms despite taking thyroxine. Secondary hypothyroidism If there is pituitary or hypothalamic disease, TSH is unreliable for diagnosing and monitoring thyroid function and fT4 should be used instead.
At the end of the trial participants were asked to identify which treatment they thought they had received in each phase. Biochemical measurements Serum thyroid stimulating hormone, free thyroxine, cholesterol, and prolactin were analysed at the time the blood was collected.