A Randomized Control Trial of Efficacy and Safety of Daily Versus Weekly Levothyroxine T4 in Hypothyroidism

Hypothyroidism is one of the most common endocrine disorders. It is found in about 6 % to 17 % of the normal population. It is more commonly seen in females and elderly. The severity of signs, symptoms and complications depends upon degree and time of untreated thyroid failure. Thyroxine also known as Levothyroxine (T4) is derived from thyroid gland itself. Although liothyronine (T3) is derived from T4 by deiodination. Various adverse effects has been noted in patients with hypothyroidism leading to poor Quality of life (QOL). Majority of the hypothyroid patients are seen with mood and cognitive symptoms. In the last few years, weekly T4 has been tested to replace daily T4 regimen because of non-compliance with the patients to weekly T4 regimen (5,6). The major reasons for non-compliance were fasting state before taking the medication early morning, not able to have other drugs or food products containing ferrous sulphate, calcium carbonates or bile acid sequestrants to prevent the interference with the absorption of levothyroxine. It was seen that non-compliance could also lead to metabolic disturbances as well. Because of all these factors affecting daily activities further leading to poor quality of life has led to the investigation of new therapeutic alternatives including weekly high dose of levothyroxine or intermittent T4 dosing further leading to better compliance in patients. Therefore, this study is planned to explore the efficacy and safety of weekly T4 dosing to daily T4 dosing by measuring the level of TSH and seeing the effect on quality of life using SF-36 scale scoring .