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May 14, 2014
Substitution Treatment Doesn’t Reduce Mortality in Subclinical Hypothyroidism Patients

Wroclaw, Poland—Although subclinical hypothyroidism has been associated with increased risk for hypertension and hypercholesterolemia, treading it with levothyroxine has no effect on overall mortality rates, according to research recently presented at the European Congress of Endocrinology.

Debate continues in the medical community on whether it is effective to prescribe levothyroxine for patients with subclinical hypothyroidism, a mild form of underactive thyroid disease where patients have raised levels of thyroid-stimulating hormone (TSH) but a normal concentration of free thyroid hormone. The treatment is generally well tolerated, but side effects can occur if thyroid hormone levels are raised too high, according to background in the presentation.

For the study, researchers from Gentofte University Hospital in Denmark examined the medical records of 628,953 patients who had received thyroid function tests from 2000 to 2009 in Copenhagen, Denmark. Of those, 12,212 patients, representing 1.9%, were diagnosed with subclinical hypothyroidism; their mean age was 55.2 and 79.8% were female.

About 20% of the subclinical hypothyroidism group, 2,483 patients, were prescribed levothyroxine within the first 6 months. The remaining 9,729 patients (79.7%) either started levothyroxine therapy later than 6 months after their initial blood test or did not receive any substitution treatment.

Over the 5-year follow-up period, 1,566 of the subclinical hypothyroidism patients died. No significant difference in mortality rates between patients who received levothyroxine treatment and those who did not were identified, the researchers report.

“This is the largest population-based study to examine whether levothyroxine treatment for patients with subclinical hypothyroidism can affect their mortality,” said lead author Mette Andersen, a research fellow. “Using readily-available registry data, we were able to examine a large population and compare treated versus untreated subclinical hypothyroidism patients with respect to all-cause mortality.”

“Our main finding was that levothyroxine treatment had no effect on overall death rates in subclinical hypothyroidism patients,” Anderson added. “Although previous studies have indicated that levothyroxine treatment may improve some markers of heart function, we found no evidence that this translates into increased survival for these patients.”





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