Is levothyroxine appropriate for subclinical hypothyroidism in the elderly?

Takeaway

• Levothyroxine is not associated with significantly improved QoL in patients aged 80+ years with subclinical hypothyroidism (SCH).

Why this matters

• The benefits of levothyroxine were unclear in this patient population.

Key results

• Thyroid-Related Quality of Life Patient-Reported Outcome (ThyPRO) hypothyroid symptoms scores showed a similar decrease in patients receiving levothyroxine and patients receiving placebo at 12 months (adjusted between-group difference, 1.27; P=.53).
  • At study end, adjusted between-group difference was −0.48 (P=.88).
• ThyPRO tiredness scores showed a similar increase in patients receiving levothyroxine and patients receiving placebo at 12 months (adjusted between-group difference, −0.10; P=.96).
  • At study end, adjusted between-group difference was −0.77 (P=.81).
• 29.5% of patients receiving levothyroxine and 28.8% of patients receiving placebo experienced a serious adverse event (estimated risk difference, −0.01; 95% CI, −0.04 to 0.01).

Study design

• 251 patients aged 80+ years with SCH pooled from 2 clinical trials were included.
• Funding: ZonMw; Swiss National Science Foundation; European Union; Swiss Heart Foundation; Velux Stiftung.

Limitations

• Anti-thyroid antibody status not available.