Trial reportJournal of the American College of Surgeons2016
Prospective Intervention of a Novel Levothyroxine Dosing Protocol Based on Body Mass Index after Thyroidectomy.
Trial report in Journal of the American College of Surgeons, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Establishing the Adequate Levothyroxine Dose After Total Thyroidectomy: A Systematic Review With Meta-analysis.The Journal of clinical endocrinology and metabolism · 2025Pooled it
- Patient-Tailored Levothyroxine Dosage with Pharmacokinetic/Pharmacodynamic Modeling: A Novel Approach After Total Thyroidectomy.Thyroid : official journal of the American Thyroid Association · 2021Trial
- Article
- Smart thyroid-regulated drug delivery systems: a review of intelligent biosensor-integrated therapeutics for precision thyroxine replacement.Frontiers in endocrinology · 2026Review
- Lean Body Mass as a Predictor of Levothyroxine Requirement in Primary Hypothyroidism as Compared to Actual Body Weight.Journal of the Endocrine Society · 2025Article
- Developing a machine learning-based predictive model for levothyroxine dosage estimation in hypothyroid patients: a retrospective study.Frontiers in endocrinology · 2025Article
- Levothyroxine dose prediction post-thyroidectomy for differentiated thyroid carcinoma.Frontiers in endocrinology · 2025Article
- A predictive model for L-T4 dose in postoperative DTC after RAI therapy and its clinical validation in two institutions.Frontiers in endocrinology · 2024Article
- Article
- Hypothyroidism.Nature reviews. Disease primers · 2022Review
- Optimal Thyroid Hormone Replacement.Endocrine reviews · 2022Article
- Appropriate dose of levothyroxine replacement therapy for hypothyroid obese patients.Journal of clinical & translational endocrinology · 2021Article
- Management of Graves Thyroidal and Extrathyroidal Disease: An Update.The Journal of clinical endocrinology and metabolism · 2020Review
- Hyperthyroidism.Gland surgery · 2020Review
- Levothyroxine Therapy in Thyrodectomized Patients.Frontiers in endocrinology · 2020Review
- Optimizing Levothyroxine Dose Adjustment After Thyroidectomy With a Decision Tree.The Journal of surgical research · 2019Article
- Identifying Predictors of Prolonged Levothyroxine Dose Adjustment After Thyroidectomy.The Journal of surgical research · 2019Article
- Levothyroxine Dose Adjustment to Optimise Therapy Throughout a Patient's Lifetime.Advances in therapy · 2019Review
- Optimal levothyroxine dose in post-total thyroidectomy patients: a prediction model for initial dose titration.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2019Article
- Rapid Relief: Thyroidectomy is a Quicker Cure than Radioactive Iodine Ablation (RAI) in Patients with Hyperthyroidism.World journal of surgery · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundWeight-based postoperative levothyroxine (LT4) dosing often fails to appropriately dose overweight and underweight patients. Previously, we created an LT4-dosing algorithm based on BMI. We hypothesize that more patients will achieve euthyroidism at their postoperative visit with the use of the protocol. STUDY
designA prospective evaluation was performed of our previously published BMI-based LT4 dosing. All adults who underwent thyroidectomy for benign disease between January 1, 2011 and December 31, 2013 were included; the new protocol was implemented in October 2012. Serum TSH was measured for all patients 6 to 8 weeks postoperatively, and adjustments were based on TSH.
resultsThree hundred and thirty patients were included, with 54% undergoing thyroidectomy after institution of the protocol. The groups were well matched. Before protocol implementation, LT4 was dosed solely by weight and 25% of patients were euthyroid at initial follow-up. After the protocol, 39% of patients were euthyroid (p = 0.01). The percentage of patients who were given too high a dose of LT4 remained the same (46% vs 42%), and there was a significant reduction in the number of patients who were given too little (29% vs 19%; p = 0.05). The effect was most profound in patients with low and normal BMI, and there were slight differences between sexes.
conclusionsAlthough correct initial dosing of LT4 remains challenging, this dosing protocol that we developed and implemented has improved patient care by increasing the number of patients who achieve euthyroidism at the first postoperative visit. We have made a change to our original protocol to incorporate sex differences into the calculation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.