ArticleThe Journal of clinical endocrinology and metabolism2018
Systemic Thyroid Hormone Status During Levothyroxine Therapy In Hypothyroidism: A Systematic Review and Meta-Analysis.
Article 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 58 papers, 1 of them a synthesis that pooled it.
What it found
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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
58 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Evidence-Based Use of Levothyroxine/Liothyronine Combinations in Treating Hypothyroidism: A Consensus Document.Thyroid : official journal of the American Thyroid Association · 2021Guideline
- Extended Absorption of Liothyronine from Poly-Zinc-Liothyronine: Results from a Phase 1, Double-Blind, Randomized, and Controlled Study in Humans.Thyroid : official journal of the American Thyroid Association · 2022Trial
- Dyslipidemias associated with endocrine disorders: a position statement of the working group of the nutrition hormones and metabolism club of the italian society of endocrinology (SIE).Journal of endocrinological investigation · 2026Review
- Treatment of mild subclinical hypothyroidism and its impact on lipid metabolism.Frontiers in endocrinology · 2026Article
- Medical Treatment of Hyperthyroidism; Efficacy and Safety Considerations.Archives of Iranian medicine · 2025Review
- Treatment of hypothyroidism with the combination of levothyroxine and slow-release triiodothyronine: a randomized clinical trial.Journal of clinical & translational endocrinology · 2025Article
- Hippocampal NLRP1 inflammasome mediates anxiety-like behavior in mice with hypothyroidism.Scientific reports · 2025Article
- Risk factors and clinical implications of thyroxine replacement therapy on major adverse cardiovascular events in type 2 diabetes: a retrospective cohort study.Frontiers in endocrinology · 2025Article
- Association between peripheral thyroid sensitivity defined by the FT3/FT4 ratio and composite adverse outcome among inpatients with heart failure.Frontiers in endocrinology · 2025Article
- Cardiovascular risk after total thyroidectomy in patients with differentiated thyroid carcinoma undergoing levothyroxine replacement monotherapy.Frontiers in endocrinology · 2025Article
- Efficacy of levothyroxine monotherapy in achieving clinical euthyroidism and its impact on weight loss in women with hypothyroidism and obesity.Scientific reports · 2024Article
- Thyroid Hormone Homeostasis in Levothyroxine-treated Patients: Findings From ELSA-Brasil.The Journal of clinical endocrinology and metabolism · 2024Article
- Increased thyroid stimulating hormone (TSH) as a possible risk factor for atherosclerosis in subclinical hypothyroidism.Thyroid research · 2024Review
- Investigating the effect of levothyroxine replacement on cholesterol levels in hypothyroid patients.Journal of family medicine and primary care · 2024Article
- Article
- Treatment of Hypothyroidism and Stress Using Neuro-Emotional Technique (NET): A Case Study.Cureus · 2024Article
- Emerging Therapies in Hypothyroidism.Annual review of medicine · 2024Review
- Demographic, Healthcare Access, and Dietary Factors Associated With Thyroid Hormone Treatments for Hypothyroidism.The Journal of clinical endocrinology and metabolism · 2023Article
- Deiodinase Type 3 Polymorphism (rs1190716) Affects Therapeutic Response to Levothyroxine.Turkish journal of pharmaceutical sciences · 2023Article
- Primary Hypothyroidism and Alzheimer's Disease: A Tale of Two.Cellular and molecular neurobiology · 2023Review
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
contextThe standard of care for overt hypothyroidism is levothyroxine at doses that normalize serum TSH levels. Whether this approach universally restores thyroid hormone signaling is unknown.
objectiveTo review studies of overt hypothyroidism in which participants were treated with levothyroxine to normalize serum TSH levels and measured other objective markers of thyroid hormone signaling.
designDatabases were searched for studies that reported objective markers of thyroid hormone signaling (serum low-density lipoprotein (LDL), total cholesterol (TC), sex hormone-binding globulin (SHBG), creatine kinase and/or ferritin levels; cognition, energy expenditure, and/or renal function) in levothyroxine monotherapy for overt, primary hypothyroidism among nonpregnant adults with normal serum TSH levels. For studies with LDL, TC and SHBG outcomes, data were pooled using random effects meta-analysis.
resultsA total of 99 studies met inclusion criteria, including 65 that reported serum cholesterol data. Meta-analysis showed that levothyroxine-treated hypothyroid participants with normal serum TSH levels had 3.31 ± 1.64 mg/dL higher serum LDL levels (p=0.044) and 9.60 ± 3.55 mg/dL higher serum TC levels (p=0.007) compared to controls. In studies that did not concomitantly assess healthy controls, serum LDL levels were 138.3 ± 4.6 mg/dL (p<0.001) and serum TC levels were 209.6 ± 3.4 mg/dL (p<0.001). Meta-analysis of 2 studies showed no significant difference between SHBG levels of levothyroxine-treated participants and controls.
conclusionsIn studies that utilized levothyroxine monotherapy at doses that normalized the serum TSH for overt, primary hypothyroidism, not all systemic biological markers of thyroid hormone signaling were normalized, including serum LDL and TC levels.
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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.