A third discontinuing levothyroxine have normal thyroid levels

About one-third of patients who undergo levothyroxine (LT4) treatment for overt hypothyroidism maintain normal thyroid levels after stopping the therapy, researchers report in Thyroid. The evidence comes from a meta-analysis of 17 observational studies with a collective 1,103 participants, mostly adult females. Approximately 37.2% of patients maintained euthyrodism 5 years after discontinuing the hormone replacement therapy—although the rate was markedly higher among those with subclinical hypothyroidism than among those with overt hypothyroidism, who were more likely to restart LT4 during followup. The finding suggests that many participants derived little benefit from the treatment in the first place, and it potentially dovetails with other research suggesting that LT4 is futile in patients with subclinical hypothyroidism. With guidelines seeming to move away from using thyroid hormones in that setting, an optimal discontinuation strategy is warranted. Nydia Burgos, MD, who led the team at the University of Puerto Rico, conceded that it will take more research to come up with a strong evidence-based protocol for deprescribing LT4.