Treatment of Hypothyroidism with Once Weekly Thyroxine1
| Autor: | Stefan K.G. Grebe, Nigel A. Lever, Jocelyn N. Fagerström, Colin M. Feek, Gordon Purdie, Diane P. Cordwell, Russell R. Cooke, H C Ford |
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| Rok vydání: | 1997 |
| Předmět: |
medicine.medical_specialty
Chemotherapy medicine.diagnostic_test business.industry Endocrinology Diabetes and Metabolism medicine.medical_treatment Biochemistry (medical) Clinical Biochemistry Thyroid Once weekly Biochemistry Thyroid function tests law.invention Endocrinology medicine.anatomical_structure Randomized controlled trial law Tissue markers Internal medicine Toxicity medicine business hormones hormone substitutes and hormone antagonists Hormone |
| Zdroj: | The Journal of Clinical Endocrinology & Metabolism. 82:870-875 |
| ISSN: | 1945-7197 0021-972X |
| DOI: | 10.1210/jcem.82.3.3830 |
| Popis: | We compared daily T4 therapy with 7 times the normal daily dose administered once weekly in 12 hypothyroid subjects in a randomized cross-over trial. At the end of each treatment we measured serum free T4 (FT4), free T3 (FT3), rT3, and TSH levels and multiple markers of thyroid hormone effects at the tissue level repeatedly for 24 h. Compared with daily administration, the mean serum TSH before the administration of weekly T4 was higher (weekly, 6.61; daily, 3.92 microIU/mL; P < 0.0001), and the mean FT4 (weekly, 0.98; daily, 1.35 ng/dL; P < 0.01) and FT3 (weekly, 208, daily, 242 pg/dL; P < 0.01) were lower. A minimally elevated serum total cholesterol during weekly administration (weekly, 246.8; daily, 232.6 mg/dL; P < 0.03) was the only evidence of hypothyroidism at the tissue level. Compared with daily administration, the mean peak FT4 following weekly administration of T4 was significantly higher (weekly, 2.71; daily, 1.59 ng/dL; P < 0.0001), as was the mean peak FT3 level (weekly, 285; daily, 246 pg/dL; P < 0.01). None of the tissue markers of thyroid hormone effect changed compared to daily T4, and there was no evidence of treatment toxicity, including cardiac toxicity. During weekly T4 administration, autoregulatory mechanisms maintain near-euthyroidism. For complete biochemical euthyroidism a slightly larger dose than 7 times the normal daily dose may be required. |
| Databáze: | OpenAIRE |
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