Endocrine Abstracts

Objective: To evaluate the effectiveness and compliance to L-thyroxine in the treatment of Hypothyroidism in a weekly dose of 7 times of normal dose as an alternative to daily dosing in young and middle aged adults.

Methods: A randomized prospective observational study on 180 patients (female:male) ratio of 5:1 aged between 18 and 55 years with an established diagnosis of Hypothyroidism were assigned a weekly dose of seven times of normal dose. The patients were randomized in 3 groups G1, G2 and G3. Group 1 (G1): 60 patients with established diagnosis of Hypothyroidism with TSH value of 4.2 or less, currently on daily dose. The subjects were assigned weekly dose of L-thyroxine which was 7-fold of normal dose. Group 2 (G2): 60 patients with established diagnoses of Hypothyroidism with TSH value of more than 4.2. The subjects were assigned weekly dose of L-thyroxine which was 7-fold of normal dose, the dose in this group was individualized as per the body weight and TSH value. Group 3 (G3): 60 patients newly established diagnoses of Hypothyroidism with TSH value of more than 4.2. The group was started with a weekly dose which was individualized as per the body weight and TSH value. All subjects in all the groups were screened for malabsorption and were not receiving any drugs which interfere with the absorption of L-thyroxine. The minimum to maximum dose used in this study was 175–1050 mcg.

Results or case presentation: We achieved complete restoration of euthyroidism in all 59 subjects in the group 1 (G1) at 12 weeks and it continued to 24 weeks. We had to withdraw it in a 55-year male patient because of hyperthyroid symptoms. In group 2 (G2), we achieved complete euthyroidism in 52 subjects at 12 weeks and it increased to 55 subjects with some dose adjustment at 24 weeks. We could not achieve euthyroidism in 5 subjects at 24 weeks. This may be attributed to other metabolic disorders like diabetes and obesity. In (G3) we achieved complete euthyroidism in 54 subjects at 12 weeks and it increased to 59 subjects with some dose adjustment at 24 weeks. 1 subject shifted to another city and so did not complete the study.

Conclusion: Once weekly dose of L-thyroxine as an alternative to daily dosing regimen was shown to be efficacious and safe for the treatment of hypothyroidism to treat non-compliant hypothyroid young- and middle-aged adults. The results show that it can be started in newly diagnosed hypothyroid patients. For patients who find it difficult to adhere to a rigorous treatment regime it is a valid therapeutic option and can also be considered as a first line therapy in young and middle aged working adults facing impaired absorption due to early breakfast (no need to wait 30–45 min for breakfast).