Real Practice Assessment of Persistent Symptoms After Initiation of Levothyroxine
Authors' conclusion
Our findings indicate that approximately 1 in every 4 patients with hypothyroidism receiving LT4 therapy and achieving normal TSH levels experience persistent or new hypothyroid symptoms. The cause of these symptoms remains unclear, emphasizing the need for a better understanding of their underlying causes and the development of effective management strategies.
Study context
- Population
- Patients with hypothyroidism starting levothyroxine (LT4), Jan 2017–Dec 2019, Mayo Clinic, Rochester, Minnesota, USA; 66.6% female, 92.3% white, 71.9% obese, average age 59.5 years500 charts reviewed
- Participants
- 356 patients
- Outcome
- Frequency of persistent or new symptoms after LT4 initiation
- Follow-up
- ≤3 visits
Methodological detailssingle-centre, random chart selection
- Single-centre
- Random chart selection
Main finding
As reported in the abstract
First follow-up period
26.7%
42/157
Second follow-up period
27.3%
29/106
Third follow-up period
28%
16/57
Observational data: associations, not effects.
Further findings
Hypothyroid symptoms at baseline visit
- Reported hypothyroid symptoms
- 177/356, 47.7%
- Fatigue the most common symptom
Persistent symptoms with normal thyroid stimulating hormone (TSH) · follow-up periods
- First follow-up period
- 17.8% (28/157)
- Second follow-up period
- 17.9% (19/106)
- Third follow-up period
- 19.3% (11/57)
New symptoms with normal TSH · follow-up periods
- First follow-up period
- 12.3% (19/156)
- Second follow-up period
- 19.9% (16/107)
- Third follow-up period
- 8.9% (5/56)
Original publication
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