Efficacy of combined levothyroxine and liothyronine as compared with levothyroxine monotherapy in primary hypothyroidism: A randomized controlled trial

Endocrine Research

Volumn 34, Issue 3, 2009, Pages 80-89

  Valizadeh, Majid ^a   Seyyed Majidi, Mohammad R ^a   Hajibeigloo, Hasan ^a   Momtazi, Saeed ^a   Musavinasab, Noreddin ^a   Hayatbakhsh, Mohammad R ^b  

^a ZANJAN UNIVERSITY OF MEDICAL SCIENCES   (Iran)

^b UNIVERSITY OF QUEENSLAND   (Australia)

Author keywords

Combination therapy; Levothyroxine monotherapy; Primary hypothyroidism

Indexed keywords

LEVOTHYROXINE; LIOTHYRONINE; LIPID; RADIOACTIVE IODINE; THYROTROPIN;

ADD ON THERAPY; ADULT; ANXIETY; ARTICLE; BLOOD STORAGE; BODY WEIGHT; CLINICAL TRIAL; COMBINATION CHEMOTHERAPY; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; DEPRESSION; DOUBLE BLIND PROCEDURE; DRUG DOSE REDUCTION; DRUG EFFICACY; DRUG WITHDRAWAL; FEMALE; GASTROINTESTINAL DISEASE; GENERAL CONDITION IMPROVEMENT; GENERAL HEALTH QUESTIONNAIRE; HEALTH STATUS; HEART PALPITATION; HEART RATE; HUMAN; HYPOTHYROIDISM; INSOMNIA; INTERMETHOD COMPARISON; LIPID BLOOD LEVEL; MAJOR CLINICAL STUDY; MALE; MENTAL HEALTH; METABOLISM; MONOTHERAPY; PRIORITY JOURNAL; QUESTIONNAIRE; RANDOMIZED CONTROLLED TRIAL; SOCIAL DISABILITY; THYROIDECTOMY; THYROTROPIN BLOOD LEVEL; TREATMENT DURATION; TREATMENT OUTCOME; WELLBEING;

ADOLESCENT; ADULT; DRUG THERAPY, COMBINATION; FEMALE; HUMANS; HYPOTHYROIDISM; MALE; MIDDLE AGED; THYROXINE; TREATMENT OUTCOME; TRIIODOTHYRONINE;

EID: 70149086054     PISSN: 07435800     EISSN: 15324206     Source Type: Journal    
DOI: 10.1080/07435800903156340     Document Type: Article

References (26)

1. Vanderpump MP, Tunbridge WM, French JM, et al. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey. Clin Endocrinol (Oxf) 1995; 43:55-68.
2. Hollowell JG, Staehling NW, Flanders WD, et al. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab 2002; 87:489-499.
3. Hendrick V, Altshuler L, Whybrow P. Psychoneuroendocrinology of mood disorders. The hypothalamic-pituitary-thyroid axis. Psychiatr Clin North Am 1998; 21:277-292.
4. Jaeschke R, Guyatt G, Cook D, Harper S, Gerstein HC. Spectrum of quality of life impairment in hypothyroidism. Qual Life Res 1994; 3:323-327.
5. Leonard J, Koehrle J. Intracellular pathways of iodothyronine metabolism. In: Braverman LE, Utiger R, eds. Werner's and Ingbar's the Thyroid: A Fundamental and Clinical Text. 7th ed. Philadelphia: Lippincott-Raven; 1996:125-126.
6. Roti E, Minelli R, Gardini E, Braverman LE. The use and misuse of thyroid hormone. Endocr Rev 1993; 14:401-423.
7. Saravanan P, Chau WF, Roberts N, Vedhara K, Greenwood R, Dayan CM. Psychological well-being in patients on 'adequate' doses of l-thyroxine: results of a large, controlled community-based questionnaire study. Clin Endocrinol (Oxf) 2002; 57:577-585.
8. Macgregor AG. Why does anybody use thyroid B.P.? Lancet 1961; 1:329-332.
9. Larsen P, Davies T, Hay I. The thyroid gland. In: Wilson J, Foster D, Kronenberg H, Larsen P, eds. Williams Textbook of Endocrinology. 8th ed. Philadelphia: WB Saunders; 1998:389-515.
10. Pilo A, Iervasi G, Vitek F, Ferdeghini M, Cazzuola F, Bianchi R. Thyroidal and peripheral production of 3,5,3c-triiodothyronine in humans by multicompartmental analysis. Am J Physiol 1990; 258:E715-E726.
11. Escobar-Morreale HF, del Rey FE, Obregon MJ, de Escobar GM. Only the combined treatment with thyroxine and triiodothyronine ensures euthyroidism in all tissues of the thyroidectomized rat. Endocrinology 1996; 137:2490-2502.
12. Escobar-Morreale HF, Obregon MJ, Escobar del Rey F, Morreale de Escobar G. Replacement therapy for hypothyroidism with thyroxine alone does not ensure euthyroidism in all tissues, as studied in thyroidectomized rats. J Clin Invest 1995; 96:2828-2838.
13. Grozinsky-Glasberg S, Fraser A, Nahshoni E, Weizman A, Leibovici L. Thyroxine-triiodothyronine combination therapy versus thyroxine monotherapy for clinical hypothyroidism: meta-analysis of randomized controlled trials. J Clin Endocrinol Metab 2006; 91:2592-2599.
14. Escobar-Morreale HF, Botella-Carretero JI, del Rey FE, de Escobar GM. Treatment of hypothyroidism with combinations of levothyroxine plus liothyronine. J Clin Endocrinol Metab 2005; 90:4946-4954.
15. Joffe RT, Brimacombe M, Levitt AJ, Stagnaro-Green A. Treatment of clinical hypothyroidism with thyroxine and triiodothyronine: a literature review and metaanalysis. Psychosomatics 2007; 48:379-384.
16. Bunevicius R, Prange AJ. Mental improvement after replacement therapy with thyroxine plus triiodothyronine: relationship to cause of hypothyroidism. Int J Neuropsychopharmacol 2000; 3:167-174.
17. Saravanan P, Simmons DJ, Greenwood R, Peters TJ, Dayan CM. Partial substitution of thyroxine (T4) with tri-iodothyronine in patients on T4 replacement therapy: results of a large community-based randomized controlled trial. J Clin Endocrinol Metab 2005; 90:805-812.
18. Siegmund W, Spieker K, Weike AI, et al. Replacement therapy with levothyroxine plus triiodothy-ronine (bioavailable molar ratio 14 : 1) is not superior to thyroxine alone to improve well-being and cognitive performance in hypothyroidism. Clin Endocrinol (Oxf) 2004; 60:750-757.
19. Escobar-Morreale HF, Botella-Carretero JI, Gomez-Bueno M, Galan JM, Barrios V, Sancho J. Thyroid hormone replacement therapy in primary hypothyroidism: a randomized trial comparing L-thyroxine plus liothyronine with L-thyroxine alone. Ann Intern Med 2005; 142:412-424.
20. Bunevicius R, Kazanavicius G, Zalinkevicius R, Prange AJ Jr. Effects of thyroxine as compared with thyroxine plus triiodothyronine in patients with hypothyroidism. N Engl J Med 1999; 340:424-429.
21. Clyde PW, Harari AE, Getka EJ, Shakir KMM. Combined levothyroxine plus liothyronine compared with levothyroxine alone in primary hypothyroidism: a randomized controlled trial. JAMA 2003; 290:2952-2958.
22. Sawka AM, Gerstein HC, Marriott MJ, MacQueen GM, Joffe RT. Does a combination regimen of thyroxine (T4) and 3,5,3c-triiodothyronine improve depressive symptoms better than T4 alone in patients with hypothyroidism? Results of a double-blind, randomized, controlled trial. J Clin Endocrinol Metab 2003; 88:4551-4555.
23. Walsh JP, Shiels L, Lim EM, et al. Combined thyroxine/liothyronine treatment does not improve well-being, quality of life, or cognitive function compared to thyroxine alone: a randomized controlled trial in patients with primary hypothyroidism. J Clin Endocrinol Metab 2003; 88:4543-4550.
24. Goldberg D. The Detection of Psychiatric Illness by Questionnaire. London: Oxford University Press; 1972.
25. Lobo A, Perez-Echeverria MJ, Artal J. Validity of the scaled version of the General Health Questionnaire (GHQ-28) in a Spanish population. Psychol Med 1986; 16:135-140.
26. Goldberg DP, Hillier VF. A scaled version of the General Health Questionnaire. Psychol Med 1979; 9:139-145.