Levothyroxine treatment response of cardiometabolic biomarkers in older adults with subclinical hypothyroidism
Authors' conclusion
In older adults with subclinical hypothyroidism, levothyroxine treatment showed no effects on cardiometabolic biomarkers, although potentially favorable changes in lipids and lipoproteins were observed for individuals with baseline TSH ≥10 mIU/L.
Study context
- Population
- Older adults (≥65 years) with SCH; 48% women; median age 75 [70, 82] years; median baseline TSH 6.44 [5.36, 7.81] mIU/L
- Participants
- 286 adults
- Comparison
- Levothyroxine vs placebo
- Levothyroxinen = 142
- Primary endpoint
- Cardiometabolic biomarkers: 7 clinically relevant lipid measures (ApoB, Total-C, non-HDL-C, RC, LDL-C, HDL-C, TG) and 167 standardized NMR metabolomic measures
- Follow-up
- 12 months
Primary result
As reported in the abstract
Clinically relevant lipid measures (levothyroxine effect)
- Levothyroxine
- Apolipoprotein B (ApoB) effect −0.03 g/L (95% CI −0.07 to 0.00)
- Levothyroxine
- Total-C effect −0.17 mmol/L (95% CI −0.34 to 0.00)
- Levothyroxine
- non-HDL-C effect −0.15 mmol/L (95% CI −0.31 to 0.00)
- Levothyroxine
- Remnant cholesterol (RC) effect −0.09 mmol/L (95% CI −0.16 to −0.01)
- Levothyroxine
- Low-density lipoprotein cholesterol (LDL-C) effect −0.07 mmol/L (95% CI −0.15 to 0.02)
- Levothyroxine
- Triglycerides (TG) effect −0.07 mmol/L (95% CI −0.15 to 0.01)
Further findings
- Participants with baseline TSH ≥10 mIU/L
- n = 27
- Potentially beneficial changes for all clinically relevant lipids except HDL-C, and for ApoB-containing lipoproteins, VLDL size and fatty acids (P < .05, not significant after multiple-testing correction)
Original publication
Levothyroxine treatment response of cardiometabolic biomarkers in older adults with subclinical hypothyroidism. J Clin Endocrinol Metab. Published 8 April 2026. doi:10.
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