Discontinuation of Levothyroxine in Adults Aged 60 Years or Older
Authors' conclusion
In this open-label, single-group prospective study, 25.7% of adults aged 60 years or older discontinued levothyroxine treatment while maintaining adequate thyroid function at 1 year. Evaluation of the need to continue levothyroxine should be considered in adults aged 60 years or older, particularly in those taking a dose of 50 µg/d or lower.
Study context
- Population
- Community-dwelling adults aged ≥60 years on stable LT4 (≤150 µg/d) for ≥1 year with TSH <10 mIU/L, 58 general practices in the Netherlands; median age 70 years, 80% female366 completed follow-up
- Participants
- 370 adults
- Outcome
- Proportion who discontinued LT4 with TSH <10 mIU/L and FT4 within reference range
- Follow-up
- 1 year after start of discontinuation
Methodological detailsopen-label, protocol-driven stepwise dose reduction, 58 general practices, Enrolled January 2020–July 2022; final follow-up December 12, 2023
- Open-label
- Protocol-driven stepwise dose reduction
- 58 general practices
- Enrolled January 2020–July 2022; final follow-up December 12, 2023
Main finding
As reported in the abstract
Successful LT4 discontinuation · 1 year
LT4 discontinuation
25.7%
95 of 370
Observational data: associations, not effects.
Secondary outcomes
Thyroid function in those who successfully discontinued · 1 year
- Median TSH (range 1.56-9.40 mIU/L)
- 5.03 mIU/L
- Mean FT4 (range 0.80-1.43 ng/dL)
- 1.01 ng/dL
- TSH <4.8 mIU/L among successful discontinuers
- 46 (48.4%) (95% CI 38.6%-58.3%)
Successful discontinuation in subgroup on LT4 dose ≤50 µg/d · 1 year
- Successfully discontinued, of 88 participants on ≤50 µg/d
- 56 (63.6%)
Thyroid-related quality of life · baseline to 1 year
- No clinically relevant changes overall or stratified by successful vs unsuccessful discontinuation
Original publication
Discontinuation of Levothyroxine in Adults Aged 60 Years or Older. JAMA. Published 6 April 2026. doi:10.
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