help button home button Endocrine Society JCEM JCEM Call for Nominations for EIC
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
This version published online on May 2, 2006
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2006-0448
A more recent version of this article appeared on July 1, 2006
This Article
Right arrow Author Manuscript (PDF)
Right arrow Supplemental Data
Right arrow All Versions of this Article:
91/7/2592    most recent
Author Manuscript (PDF)
Right arrow Submit a related Letter to the Editor
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Copyright Permission
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Grozinsky-Glasberg, S.
Right arrow Articles by Leibovici, L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Grozinsky-Glasberg, S.
Right arrow Articles by Leibovici, L.

Submitted on February 27, 2006
Accepted on April 24, 2006

Thyroxine-Triiodothyronine Combination Therapy versus Thyroxine Monotherapy for Clinical Hypothyroidism - Meta-analysis of Randomized Controlled Trials

Simona Grozinsky-Glasberg, Abigail Fraser, Ethan Nahshoni, Abraham Weizman, and Leonard Leibovici*

Endocrine Institute and Department of Medicine E, Rabin Medical Center, Beilinson Campus, Petah-Tiqva 49100, Israel; Geha Mental Health Center, Petah-Tiqva 49100, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Tel-Aviv, Israel

* To whom correspondence should be addressed. E-mail: leibovic{at}post.tau.ac.il.

Context: In some patients symptoms of hypothyroidism persist despite therapy with thyroxine (T4).

Objective: To compare the effectiveness of thyroxine-triiodothyronine (T4-T3) combination vs. T4 monotherapy for the treatment of clinical hypothyroidism in adults.

Data sources: Pub Med, EMBASE, LILACS, and The Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched in September 2005. References of all included trials were scanned for additional studies. We put no restrictions on language, year of publication, or publication status.

Study selection: All randomized trials that compared the effectiveness of thyroxine-triiodothyronine combination vs. thyroxine monotherapy for the treatment of clinical hypothyroidism in adults were included.

Data extraction: By 2 independent reviewers.

Data synthesis: We included 11 studies, in which 1216 patients were randomized. No difference was found in the effectiveness of combination vs. monotherapy in any of the following symptoms: bodily pain (standardized mean difference (SMD) 0.00, 95% confidence interval (CI) -0.34, 0.35), depression (SMD 0.07; 95% CI -0.20, 0.34), anxiety (SMD 0.00, 95% CI -0.12, 0.11), fatigue (SMD -0.12, 95% CI -0.33, 0.09), quality of life (SMD 0.03, 95% CI -0.09, 0.15), body weight, total serum cholesterol, triglyceride levels, LDL and HDL. Adverse events did not differ between regimens.

Conclusions: T4 monotherapy should remain the treatment of choice for clinical hypothyroidism.
Key words: Thyroxine-Triiodothyronine combination therapy • symptoms • quality of life • cognition • meta-analysis




This article has been cited by other articles:


Home page
 JAMAHome page
J. Jonklaas, B. Davidson, S. Bhagat, and S. J. Soldin
Triiodothyronine Levels in Athyreotic Individuals During Levothyroxine Therapy
JAMA, February 20, 2008; 299(7): 769 - 777.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
D. S. Cooper
Thyroxine Monotherapy After Thyroidectomy: Coming Full Circle
JAMA, February 20, 2008; 299(7): 817 - 819.
[Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
P. Saravanan, T. J. Visser, and C. M. Dayan
Psychological Well-Being Correlates with Free Thyroxine But Not Free 3,5,3'-Triiodothyronine Levels in Patients on Thyroid Hormone Replacement
J. Clin. Endocrinol. Metab., September 1, 2006; 91(9): 3389 - 3393.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Endocrinology Endocrine Reviews J. Clin. End. & Metab.
Molecular Endocrinology Recent Prog. Horm. Res. All Endocrine Journals
Copyright © 2006 by The Endocrine Society