Thyroid

360
-1

Published on

Published in: Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
360
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
4
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Thyroid

  1. 1. Namrata Dass
  2. 3. STUDY PARTICIPANTS <ul><li>18 years or older </li></ul><ul><li>On stable levothyroxine regimen for at least 6 months </li></ul><ul><li>Patients with a gastrointestinal tract disorder, those with thyroid carcinoma, and those who were pregnant were excluded from the study </li></ul><ul><li>Also excluded were patients who were taking medication known to interfere with the uptake of levothyroxine </li></ul>
  3. 4.   RANDOMIZATION AND TREATMENT <ul><li>patients were randomized to start the study period with 1 capsule of levothyroxine in the morning (and 1 capsule of placebo at bedtime) or with 1 capsule of levothyroxine at bedtime(and 1 capsule of placebo at bedtime) </li></ul><ul><li>After 3 months, patients were switched from levothyroxine in the morning to placebo and vice versa for another 3 months </li></ul>
  4. 5. DATA COLLECTION AND FOLLOW UP <ul><li>At baseline and every 6 weeks pt were seen in the clinic </li></ul><ul><li>Plasma thyrotropin, FT4, T3, creatinine, and lipid levels, and blood pressure, heart rate, and body weight were measured. </li></ul><ul><li>The remaining capsules in the containers were counted to check for compliance </li></ul>
  5. 6. QUALITY OF LIFE <ul><li>  </li></ul><ul><li>Three QOL questionnaires (36-Item Short Form Health Survey, Hospital Anxiety and Depression Scale, and 20-Item Mul- tidimensional Fatigue Inventory) and a specific questionnaire about symptoms of hypothyroidism and hyperthyroidism were completed by patients at baseline, at 3 months, and at the end of the study. </li></ul>
  6. 7. STATISTICAL ANALYSIS <ul><li>Primary end point was a change in thyroid hormone variables between 12 weeks of morning levothyroxine intake and 12 weeks of bedtime levothyroxine intake </li></ul><ul><li>Secondary end points were changes in QOL ,thyroid symptom score, body mass index, heart rate, and serum lipid and creatinine levels </li></ul>
  7. 9. PATIENT PREFERENCE <ul><li>34 of 90 patients said that they felt better during the period of morning intake of levo- thyroxine </li></ul><ul><li>31 patients preferred the period of bedtime intake </li></ul><ul><li>25 patients indicated no preference </li></ul><ul><li>After the trial more than half patient preferred evening intake of levothyroxine </li></ul>
  8. 10. COMMENT <ul><li>Bedtime levothyroxine intake could be more convenient for patients, as they do not have to postpone breakfast. </li></ul><ul><li>An interval of 30 minutes between taking levothyroxine and eating breakfast may be too short to prevent interference with gastrointestinal absorption of levothyroxine. </li></ul>
  9. 11. <ul><li>Pt may take other medications that interfere with levothyroxine absorption in morning </li></ul><ul><li>Bowel motility is slower at night, resulting in more prolonged exposure of levothyroxine to the intestinal wall and, consequently, in better bioavailability. </li></ul><ul><li>Basal gastric acid secretion is highest in the late evening and is lowest in the morning. </li></ul>

×