International Journal of Diabetes and Endocrinology
Volume 4, Issue 1, March 2019, Pages: 1-5
Received: Dec. 15, 2018;
Accepted: Dec. 28, 2018;
Published: Jan. 29, 2019
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Abul Kalam Mohammad Aminul Islam, Department of Endocrinology, Colonel Abdul Malek Medical College, Manikganj, Bangladesh
Abul Bashar Mohammad Kamrul Hasan, Department of Endocrinology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh
Moinul Islam, Department of Endocrinology, Dhaka Medical College Hospital, Dhaka, Bangladesh
Mohammad Asaduzzaman, Medicine Outpatient Department, Shaheed Sheikh Abu Naser Specialized Hospital, Khulna, Bangladesh
Mohammad Rafiq Uddin, Department of Endocrinology, Chittagong Medical College Hospital, Chittagong, Bangladesh
Shiropa Islam, Department of Dermatology, Kurmitola General Hospital, Dhaka, Bangladesh
Mohammed Fariduddin, Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
Weight loss due to diuresis is an early clinical response of treatment with levothyroxine in primary hypothyroidism. The objective of this study was to evaluate weight changes in patients with primary hypothyroidism after 6 weeks of initiation of treatment with levothyroxine. This prospective observational follow up study included 99 newly diagnosed primary hypothyroid patients of 18-60 years of age of both sexes. The weight and height of each patient were measured and body mass index (BMI) was calculated both at the time of enrollment and at the end of 6 weeks of treatment with levothyroxine, and variables at the baseline and at follow up were compared. 93 patients out of 99 completed follow-up at 6±1 weeks. There were significant reduction in TSH level (85.1±51.6 vs. 1.87±0.9 µIU/mL, mean±SD) and increase in FT4 level (0.49±0.19 vs. 1.4±0.78 ng/dL, mean±SD) at follow up in comparison to their baseline values. Among the participants, 90.3% lost body weight while 5.4% gained weight and 4.3% of subjects didn’t show any change in their weight at the end of the study. The mean body weight and mean BMI after levothyroxine replacement were significantly lower (weight 62.2±13.7 vs. 59.0±12.1 kg, BMI 25.1±4.6 vs. 23.8±4.1 Kg/M2, mean±SD) than the pretreatment values. The mean changes in body weight and BMI were 3.19±0.32 Kg (mean±SEM) and 1.31±0.14 Kg/M2 (mean±SEM) respectively. The mean changes in body weight and BMI did not differ significantly among subjects with different TSH categories. No statistically significant effect of any individual predictors like age, gender, and socioeconomic status, weight at baseline, baseline TSH, baseline FT4 and presence of thyroid autoimmunity was observed on weight change. Levothyroxine replacement was associated with a significant reduction of mean body weight and BMI at short-term follow up in our study, though not all patients experienced weight loss.
Abul Kalam Mohammad Aminul Islam,
Abul Bashar Mohammad Kamrul Hasan,
Mohammad Rafiq Uddin,
Short-Term Weight Changes in Treated Primary Hypothyroid Subjects, International Journal of Diabetes and Endocrinology.
Vol. 4, No. 1,
2019, pp. 1-5.
D. S. Cooper and P. W. Ladenson, “The Thyroid Gland,” in Greenspan’s Basic & Clinical Endocrinology, 9th Edition, D. G. Gardner and D. Shoback, Eds. New York: The McGraw-Hill Companies, 2007, pp. 163-226.
Canaris, G. J., Manowitz, N. R., Mayor, G., & Ridgway, E. C. (2000). The Colorado thyroid disease prevalence study. Arch Intern Med, 160, 526-34.
Hollowell, J. G., Staehling, N. W., Flanders, W. D., Hannon, W. H., Gunter, E. W., Spencer, C. A., et al. (2002). Serum TSH, T (4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab, 87, 489-99.
Hoogendoorn, E. H., Hermus, A. R., de Vegt. F., Ross, H. A., Verbeek, A. L., Kiemency, L. A., et al. (2006) Thyroid function and prevalence of anti-thyroperoxidase antibodies in a population with borderline sufficient iodine intake: Influences of age and sex. Clin Chem, 52, 104-11.
Unnikrishnan, A. G., Kalra, S., Sahay, R. K., Bantwal, G., John, M., & Tewari, N. (2013). Prevalence of hypothyroidism in adults: An epidemiological study in eight cities of India. Indian J Endocr Metab, 17, 647-52.
Fish, L. H., Schwartz, H. L., Cavanaugh, J., Steffes, M. W., Bantle, J. P., & Oppenheimer, J. H. (1987). Replacement dose, metabo¬lism, and bioavailability of levothyroxine in the treatment of hypothyroidism. Role of triiodothyronine in pituitary feedback in humans. N Engl J Med, 316, 764-70.
Roos, A., Linn-Rasker, S. P., van Domburg, R. T., Tijssen, J. P., & Berghout, A. (2005). The Starting Dose of Levothyroxine in Primary Hypothyroidism Treatment. A Prospective, Randomized, Double-blind. Arch Intern Med, 2005, 165, 1714-20.
Karmisholt, J., Andersen, S., & Laurberg, P. (2011). Weight loss after therapy of hypothyroidism is mainly caused by excretion of excess body water associated with myxoedema. J Clin Endocrinol Metab, 2011, 96, E99-103.
Sahu´n, M., Villabona, C., Rosel, P., Navarro, M. A., Ramo´n, J. M., Go´mez, J. M., & Soler, J. (2001). Water metabolism disturbances at different stages of primary thyroid failure. J Endocrinol, 168, 435-45.
Park, C. W., Shin, Y. S., Ahn, S. J., Kim, S. Y., Choi, E. J., Chang, Y. S., & Bang, B. K. (2001). Thyroxine treatment induces upregulation of renin-angiotensin-aldosterone system due to decreasing effective plasma volume in patients with primary myxoedema. Nephrol Dial Transplant, 16, 1799-806.
Parving, H. H., Hansen, J. M., Nielsen, S. L., Rossing, N., Munck, O., & Lassen, N. A. (1979). Mechanisms of edema formation in myxedema: increased protein extravasation and relatively slow lymphatic drainage. N Engl J Med, 301, 460-5.
Plummer, W. A. (1940). Body weight in spontaneous myxedema. Trans Am Assoc Study Goiter, 88-98.
Hoogwerf, B. J., & Nuttall, F. Q. (1984). Long-term weight regulation in treated hyperthyroid and hypothyroid subjects. Am J Med, 76, 963-70.
Lee, S. Y., Braverman, L. E., & Pearce, E. N. (2014). Changes in body weight after treatment of primary hypothyroidism with levothyroxine. Endocr Pract, 20, 1122-8.
Lomenick, J. P., El-Sayyid, M., & Smith, W. J. (2008). Effect of levo-thyroxine treatment on weight and body mass index in children with acquired hypothyroidism. J Pediatr, 152, 96-100.