To compare the efficacy and safety of 5 days a week levothyroxine versus daily replacement therapy in hypothyroid patients: An experience from a tertiary care center in Central India

Abstract

Introduction: Hypothyroidism is a common endocrine disorder and associated with several complications if not diagnosed and managed. Levothyroxine (LT4) replacement therapy is the treatment of choice. Levothyroxine has a long half-life of 6–7 days and hence can be given intermittently keeping the weekly dose the same. Aim: The aim of the study was to compare the efficacy and safety of 5 days a week levothyroxine versus daily replacement therapy in patients with hypothyroidism and to identify the patient’s satisfaction level at the end of the trial. Methods: This was a prospective cohort study in which patients diagnosed with hypothyroidism and having stable thyroid function in the last 6 months with a minimum of two normal thyroid profile reports on the same LT4 dose were shifted 5 days a week LT4 (keeping the total weekly dose the same) after informed consent. Then, patients were followed up at regular intervals, and biochemical analysis of thyroid profile was done at 12 and 24 weeks or Si Opus Sit (SOS)according to clinical judgment. Results: One hundred and fifty patients with hypothyroidism were included in the study with a male-to-female ratio of 4:21. The mean age of our patients was 40.6 ± 8.58 years. The mean duration of hypothyroidism was 5.9 ± 3.01 years. The mean thyroid-stimulating hormone, T4, and T3 at baseline were 3.22 + 0.91 μIU/mL, 8.71 + 1.91 μg/dL, and 0.93 + 0.04 ng/mL, and at 12 weeks and 24 weeks were 3.62 ± 0.82 μIU/mL, 8.01 ± 2.01 μg/dL, and 1.2 ± 0.05 ng/mL and 3.33 ± 0.79 μIU/mL, 8.36 ± 1.99 μg/dL, and 0.88 ± 0.03 ng/mL, respectively. One hundred and twenty-seven patients did not require any dose adjustment. There was no significant difference in thyroid profile. Conclusion: Five days a week levothyroxine replacement regimen is noninferior to daily levothyroxine replacement regimen in treating patients with hypothyroidism and can be conveniently prescribed. Furthermore, 5 days regimen increased the compliance and satisfaction level in patients with hypothyroidism.