Trial reportThe Journal of clinical endocrinology and metabolism2018
Effects of Altering Levothyroxine (L-T4) Doses on Quality of Life, Mood, and Cognition in L-T4 Treated Subjects.
Trial report in The Journal of clinical endocrinology and metabolism, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
35 citing papers in PubMed, 3 syntheses or guidelines pooled it, 81 citations in OpenAlex.
- ETA guidelines for the use of levothyroxine sodium preparations in monotherapy to optimize the treatment of hypothyroidism.European thyroid journal · 2025Guideline
- LT4/LT3 Combination Therapy vs. Monotherapy with LT4 for Persistent Symptoms of Hypothyroidism: A Systematic Review.International journal of molecular sciences · 2024Pooled it
- Cognitive functioning in thyroid cancer survivors: a systematic review and meta-analysis.Journal of cancer survivorship : research and practice · 2019Pooled it
- The effect of synbiotic supplementation on hypothyroidism: A randomized double-blind placebo controlled clinical trial.PloS one · 2023Trial
- Effects of Altering Levothyroxine Dose on Energy Expenditure and Body Composition in Subjects Treated With LT4.The Journal of clinical endocrinology and metabolism · 2018Trial
- Relationship Between Body Composition and Quality of Life in Young Patients With Differentiated Thyroid Carcinoma After Thyroidectomy.International journal of endocrinology · 2026Article
- No Association Between Diet Quality, Nutritional Status, and Quality of Life in Women with Hashimoto's Thyroiditis-A Cross-Sectional Study.Nutrients · 2025Article
- Clinical thyroidology: beyond the 1970s' TSH-T4 Paradigm.Frontiers in endocrinology · 2025Review
- Quality of life, daily functioning, and symptoms in hypothyroid patients on thyroid replacement therapy: A Dutch survey.Journal of clinical & translational endocrinology · 2024Article
- Effect of thyroid-stimulating hormone suppression on quality of life in thyroid lobectomy patients: interim analysis of a multicenter, randomized controlled trial in low- to intermediate-risk thyroid cancer patients (MASTER study).Annals of surgical treatment and research · 2024Article
- Critical Approach to Hypothyroid Patients With Persistent Symptoms.The Journal of clinical endocrinology and metabolism · 2023Article
- Symptoms in Patients Being Treated for Hypothyroidism: New Data in a Continuing Controversy.Thyroid : official journal of the American Thyroid Association · 2023Article
- Serum Thyrotropin and Triiodothyronine Levels in Levothyroxine-treated Patients.The Journal of clinical endocrinology and metabolism · 2023Observational
- Brain Fog in Hypothyroidism: What Is It, How Is It Measured, and What Can Be Done About It.Thyroid : official journal of the American Thyroid Association · 2022Review
- Article
- Hypothyroidism.Nature reviews. Disease primers · 2022Review
- Use of thyroid hormones in hypothyroid and euthyroid patients: a 2020 THESIS questionnaire survey of members of the Czech Society of Endocrinology.BMC endocrine disorders · 2022Article
- Primary hypothyroidism and quality of life.Nature reviews. Endocrinology · 2022Review
- Enhanced Well-Being Associated with Thyrotoxicosis: A Neglected Effect of Thyroid Hormones?International journal of endocrinology and metabolism · 2022Review
- Hashimoto thyroiditis: an evidence-based guide to etiology, diagnosis and treatment.Polish archives of internal medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
Background: The brain is a critical target organ for thyroid hormone, but it is unclear whether variations in thyroid function within and near the reference range affect quality of life, mood, or cognition. Methods: A total of 138 subjects with levothyroxine (L-T4)-treated hypothyroidism and normal thyrotropin (TSH) levels underwent measures of quality of life (36-Item Short Form Health Survey, Underactive Thyroid-Dependent Quality of Life Questionnaire), mood (Profile of Mood States, Affective Lability Scale), and cognition (executive function, memory). They were then randomly assigned to receive an unchanged, higher, or lower L-T4 dose in double-blind fashion, targeting one of three TSH ranges (0.34 to 2.50, 2.51 to 5.60, or 5.61 to 12.0 mU/L). Doses were adjusted every 6 weeks based on TSH levels. Baseline measures were reassessed at 6 months. Results: At the end of the study, by intention to treat, mean L-T4 doses were 1.50 ± 0.07, 1.32 ± 0.07, and 0.78 ± 0.08 μg/kg (P < 0.001), and mean TSH levels were 1.85 ± 0.25, 3.93 ± 0.38, and 9.49 ± 0.80 mU/L (P < 0.001), respectively, in the three arms. There were minor differences in a few outcomes between the three arms, which were no longer significant after correction for multiple comparisons. Subjects could not ascertain how their L-T4 doses had been adjusted (P = 0.55) but preferred L-T4 doses they perceived to be higher (P < 0.001). Conclusions: Altering L-T4 doses in hypothyroid subjects to vary TSH levels in and near the reference range does not affect quality of life, mood, or cognition. L-T4-treated subjects prefer perceived higher L-T4 doses despite a lack of objective benefit. Adjusting L-T4 doses in hypothyroid patients based on symptoms in these areas may not result in significant clinical improvement.
Indexed as
Identifiers
What OpenQuestion holds
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.