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L-Thyroxine Therapy in Subclinical Hypothyroidism: A Double-Blind, Placebo-Controlled Trial

DAVID S. COOPER, M.D.; RACHELLE HALPERN, M.D.; LAWRENCE C. WOOD, M.D.; ANN A. LEVIN, M.S.; and E. CHESTER RIDGWAY, M.D.
[+] Article and Author Information

Grant support: by Grant AM-16791 from the U.S. Public Health Service and Grant RR1066 from the Clinical Research Center. Dr. Cooper is the recipient of a New Investigator Research Award (R23 AM28465-01).

▸Requests for reprints should be addressed to Dr. David Cooper; Thyroid Unit, Massachusetts General Hospital; Boston, MA 02114.


Boston, Massachusetts


© 1984 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1984;101(1):18-24. doi:10.7326/0003-4819-101-1-18
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The indications for treating patients with subclinical hypothyroidism (normal serum thyroxine and free thyroxine levels, but elevated serum thyrotrophin levels) are poorly defined. In this study, 33 patients with subclinical hypothyroidism were randomly assigned in a double-blind manner to receive placebo or L-thyroxine therapy and were followed for 1 year with thyroid function tests, serum lipid measurements, basal metabolic rate and systolic time interval determinations, and a questionnaire on hypothyroid symptoms. The placebo group showed no changes in thyroid function or peripheral indices of thyroid hormone action. In the thyroxine-treated group, serum lipids and the mean systolic time interval did not change, but the systolic time intervals became normal in the 5 patients with the most abnormal baseline values. Symptoms improved in 8 of 14 patients receiving thyroxine and in 3 of 12 patients receiving placebo (p < 0.05). L-Thyroxine therapy may be useful for patients with subclinical hypothyroidism with abnormal myocardial contractility or symptoms consistent with mild hypothyroidism, or both.

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