Trial reportThe Journal of clinical endocrinology and metabolism2018
Effects of Altering Levothyroxine Dose on Energy Expenditure and Body Composition in Subjects Treated With LT4.
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 17 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
17 citing papers in PubMed, 3 syntheses or guidelines pooled it, 33 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
- Weight Gain After Thyroidectomy: A Systematic Review and Meta-Analysis.The Journal of clinical endocrinology and metabolism · 2021Pooled it
- A feasibility double-blind trial of levothyroxine vs. levothyroxine-liothyronine in postsurgical hypothyroidism.Frontiers in endocrinology · 2025Trial
- The complexity of the relationship between thyroid disease and body weight.Nature reviews. Endocrinology · 2026Review
- Relationship Between Body Composition and Quality of Life in Young Patients With Differentiated Thyroid Carcinoma After Thyroidectomy.International journal of endocrinology · 2026Article
- Critical Approach to Hypothyroid Patients With Persistent Symptoms.The Journal of clinical endocrinology and metabolism · 2023Article
- Serum Thyrotropin and Triiodothyronine Levels in Levothyroxine-treated Patients.The Journal of clinical endocrinology and metabolism · 2023Observational
- Higher thyroid hormone has a negative association with lower limb lean body mass in euthyroid older adults: Analysis from the Baltimore Longitudinal study of aging.Frontiers in aging · 2023Article
- Article
- Hashimoto thyroiditis: an evidence-based guide to etiology, diagnosis and treatment.Polish archives of internal medicine · 2022Article
- Optimal Thyroid Hormone Replacement.Endocrine reviews · 2022Article
- Restoration of euthyroidism with levothyroxine: implications of etiology of hypothyroidism and the degree of residual endogenous thyroid function.Frontiers in endocrinology · 2022Review
- T4 + T3 combination therapy: any progress?Endocrine · 2019Review
- Thyroid Hormone Action and Energy Expenditure.Journal of the Endocrine Society · 2019Review
- Use of Thyroid Hormones in Hypothyroid and Euthyroid Patients: A Thesis* Questionnaire Survey of Romanian Physicians *Thesis: Treatment of Hypothyroidism in Europe by Specialists: an International Survey.Acta endocrinologica (Bucharest, Romania : 2005)Article
- A Meta-Analysis Examining the Impact of Levothyroxine Supplementation on Gestational Weight Gain in Women with Overt Hypothyroidism.Iranian journal of nursing and midwifery researchReview
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 2 institutions in 1 country.
Funding
Abstract
Background: It is unclear whether variations in thyroid status within or near the reference range affect energy expenditure, body mass, or body composition. Methods: 138 subjects treated with levothyroxine (LT4) for hypothyroidism with normal TSH levels underwent measurement of total, resting, and physical activity energy expenditure; thermic effect of food; substrate oxidation; dietary intake; and body composition. They were assigned to receive an unchanged, higher, or lower LT4 dose in randomized, 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). The doses were adjusted every 6 weeks to achieve target TSH levels. Baseline measures were reassessed at 6 months. Results: At study end, the mean LT4 doses and TSH levels were 1.50 ± 0.07, 1.32 ± 0.07, and 0.78 ± 0.08 µg/kg (P < 0.001) and 1.85 ± 0.25, 3.93 ± 0.38, and 9.49 ± 0.80 mU/L (P < 0.001), respectively, in the three arms. No substantial metabolic differences in outcome were found among the three arms, although direct correlations were observed between decreases in thyroid status and decreases in resting energy expenditure for all subjects. The subjects could not ascertain how their LT4 dose had been adjusted but the preferred LT4 dose they perceived to be higher (P < 0.001). Conclusions: Altering LT4 doses in subjects with hypothyroidism to vary TSH levels in and near the reference range did not have major effects on energy expenditure or body composition. Subjects treated with LT4 preferred the perceived higher LT4 doses despite a lack of objective effect. Our data do not support adjusting LT4 doses in patients with hypothyroidism to achieve potential improvements in weight or body composition.
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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.