TY - JOUR
T1 - No Effect of Levothyroxine on Hemoglobin in Older Adults With Subclinical Hypothyroidism
T2 - Pooled Results From 2 Randomized Controlled Trials
AU - du Puy, Robert S.
AU - Poortvliet, Rosalinde K. E.
AU - Mooijaart, Simon P.
AU - Stott, David J.
AU - Quinn, Terry
AU - Sattar, Naveed
AU - Westendorp, Rudi G. J.
AU - Kearney, Patricia M.
AU - McCarthy, Vera J. C.
AU - Byrne, Stephen
AU - Rodondi, Nicolas
AU - Baretella, Oliver
AU - Collet, Tinh-Hai
AU - van Heemst, Diana
AU - Dekkers, Olaf M.
AU - Jukema, J. Wouter
AU - Smit, Johannes W. A.
AU - Gussekloo, Jacobijn
AU - den Elzen, Wendy P. J.
N1 - Publisher Copyright: © 2022 The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society.
PY - 2022/6/1
Y1 - 2022/6/1
N2 - Context: Subclinical thyroid dysfunction and anemia are common disorders, and both have increasing prevalence with advancing age. Objective: The aim of this study was to assess whether levothyroxine treatment leads to a rise in hemoglobin levels in older persons with subclinical hypothyroidism. Methods: This preplanned combined analysis of 2 randomized controlled trials included community-dwelling persons aged 65 years and older with subclinical hypothyroidism who were randomly assigned to levothyroxine or placebo treatment. The levothyroxine dose was periodically titrated aiming at thyroid stimulating hormone (TSH) level within the reference range, with mock titrations in the placebo group. The main outcome measure was the change in hemoglobin level after 12 months. Results: Analyses included 669 participants (placebo n = 337, levothyroxine n = 332) with a median age of 75 years (range, 65-97) and mean baseline hemoglobin of 13.8 ± 1.3 g/dL. Although levothyroxine treatment resulted in a reduction in TSH from baseline after 12 months of follow-up compared with placebo, the change in hemoglobin level was not different between the levothyroxine and the placebo groups (-0.03 g/dL [95% CI, -0.16 to 0.11]). Similar results were found in stratified analyses including sex, age, or TSH levels. No difference in change of hemoglobin levels after 12 months was identified in 69 participants with anemia at baseline (-0.33 g/dL [95% CI, -0.87 to 0.21]). Conclusion: In persons aged 65 years and older with subclinical hypothyroidism, treatment with levothyroxine does not lead to a rise in hemoglobin levels, regardless of the presence of anemia.
AB - Context: Subclinical thyroid dysfunction and anemia are common disorders, and both have increasing prevalence with advancing age. Objective: The aim of this study was to assess whether levothyroxine treatment leads to a rise in hemoglobin levels in older persons with subclinical hypothyroidism. Methods: This preplanned combined analysis of 2 randomized controlled trials included community-dwelling persons aged 65 years and older with subclinical hypothyroidism who were randomly assigned to levothyroxine or placebo treatment. The levothyroxine dose was periodically titrated aiming at thyroid stimulating hormone (TSH) level within the reference range, with mock titrations in the placebo group. The main outcome measure was the change in hemoglobin level after 12 months. Results: Analyses included 669 participants (placebo n = 337, levothyroxine n = 332) with a median age of 75 years (range, 65-97) and mean baseline hemoglobin of 13.8 ± 1.3 g/dL. Although levothyroxine treatment resulted in a reduction in TSH from baseline after 12 months of follow-up compared with placebo, the change in hemoglobin level was not different between the levothyroxine and the placebo groups (-0.03 g/dL [95% CI, -0.16 to 0.11]). Similar results were found in stratified analyses including sex, age, or TSH levels. No difference in change of hemoglobin levels after 12 months was identified in 69 participants with anemia at baseline (-0.33 g/dL [95% CI, -0.87 to 0.21]). Conclusion: In persons aged 65 years and older with subclinical hypothyroidism, treatment with levothyroxine does not lead to a rise in hemoglobin levels, regardless of the presence of anemia.
KW - RCT
KW - anemia
KW - older adults
KW - subclinical hypothyroidism
KW - thyroid
UR - http://www.scopus.com/inward/record.url?scp=85130643564&partnerID=8YFLogxK
U2 - https://doi.org/10.1210/clinem/dgac106
DO - https://doi.org/10.1210/clinem/dgac106
M3 - Article
C2 - 35218666
SN - 0021-972X
VL - 107
SP - E2339-E2347
JO - Journal of clinical endocrinology and metabolism
JF - Journal of clinical endocrinology and metabolism
IS - 6
ER -