L-thyroxine does not improve subclinical hypothyroidism in those 65 or older

(HealthDay)—L-thyroxine does not improve hypothyroid symptoms or tiredness among older adults with subclinical hypothyroidism (SCH) and high symptom burden, according to a study published online May 5 in the Annals of Internal Medicine.

Maria de Montmollin, M.D., from the Bern University Hospital in Switzerland, and colleagues examined whether L-thyroxine improves hypothyroid symptoms and tiredness among older adults with SCH and greater symptom burden in a secondary analysis of a randomized trial. Data were included for 638 participants aged 65 years or older with persistent SCH; 132 had hypothyroid symptoms scores greater than 30, and 133 had tiredness scores greater than 40.

The researchers found that among adults with high symptom burden, there was similar improvement in the hypothyroid symptoms score for those receiving L-thyroxine and placebo (mean within-group change, −12.3 and −10.4, respectively, at one year). Similar improvements were also seen between those receiving L-thyroxine and placebo in the tiredness score (mean within-group change, −8.9 and −10.9, respectively). No evidence was seen for baseline hypothyroid symptoms or tiredness scores modifying the effects of L-thyroxine or placebo.

"In the absence of another randomized clinical trial specifically designed for persons with SCH and high symptom burden, these results do not support routine L-thyroxine therapy among older adults with SCH, including those with greater hypothyroid symptom burden and tiredness," the authors write.

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