One Year Randomized Study of L-Thyroxin Treatment in Women with Subclinical Hypothyroidism

Introduction: Subclinical hypothyroidism (SCH) is a laboratory finding which may be asymptomatic or associated with signs and symptoms of hypothyroidism. However, benefits of L-Thyroxin (LT4) treatment are not well established. Aim of the Work: The aim of the study was to evaluate the impact of treatment of SCH on thyroid clinical scores, bone mineral density (BMD), cardiac function and health related quality of life (HR-QOL). Subjects and Methods: a total number of 65 women, who were diagnosed with SCH, constituted the study subjects. They were within the age range of 40-70 years. They were randomly divided into two groups (group I, included 25 patients who were treated with L Thyroxin (L-T4), and group II included 40 women with SCH who were not treated and kept under follow up for one year. Effects of L-T4 treatment on BMI, cardiac function, BMD, lipid profile, thyroid clinical score and HR-QOL were assessed. Results: After one year; regarding body mass index (BMI), Group II had significantly higher BMI (p=0.006) though the percentage change of BMI after one year was comparable in the two groups. Total thyroid clinical score and the total HR-QOL score were significantly lower in Group I compared to group II (p < 0.001). Regarding thyroid hormone profile; free T4 was significantly higher and thyroid stimulating hormone (TSH) was significantly lower in-group I compared to group II (p=0.033 & p < 0.001 respectively). Conclusion: LT4 treatment for women with SCH was found to improve total clinical thyroid score, HR-QOL, systolic and diastolic dysfunction besides lowering TC, LDL and TG levels. However, there was evidence of bone loss in patients with SCH treated with L-T4. Thus, decision to treat or not should be individualized according to the patient’s risk benefit ratio assessment.