hypothyroidism
Conditions
Interventions
Stepwise levothyroxine treatment discontinuation. Levothyroxine at a dose of
Sponsors
Leids Universitair Medisch Centrum
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: Community dwelling patients and nursing home patients aged 60 and over using levothyroxine continuously for a minimum of 1 year at a stable dose.
Exclusion criteria
Exclusion criteria: - Last measurement of TSH (thyroid stimulating hormone) >=10 mU/L during levothyroxine treatment - A history of thyroidectomy, radioactive iodine treatment, neck irradiation, congenital hypothyroidism or secondary hypothyroidism - Concurrent amiodarone or lithium use - Concurrent use of liothyronine, thiamazole, carbimazole or propylthiouracil. - Patients using a dose of more than 150 mcg levothyroxine per day - Diagnosis of heart failure NYHA grade IV - Diagnosis of dementia - Incapacitated adults - Life-expectancy of less than 6 months - Participation in ongoing trials of therapeutic interventions - Persons that plan to move out of the region in which the study is being conducted in the next months
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary outcome is the proportion of participants that withdraw their thyroid medication successfully (defined as normal fT4 levels and TSH levels | — |
Secondary
| Measure | Time frame |
|---|---|
| Effects of discontinuing levothyroxine on: - Thyroid-related quality of life including somatic, psychological and social domains - General health - Treatment satisfaction for medication - Daily functioning Proportion of levothyroxine users who can achieve a substantial dose lowering of their levothyroxine dose after one year. Demographic, clincal characteristics and attitudes towards discontinuation of those levothyroxine users aged 60 years and older willing to discontinue levothyroxine treatment and those successfully reducing their dosage. Characteristics of persons aged 60 years and older that physicians consider safe to withdraw thyroid medication from, and medical reasons not to discontinue treatment. Frequency of discontinuation (or stepping-down) levothyroxine treatment by general practitioners in usual care . Physicians* experience on the recruitment of patients and the consultations, Study participants* experience of discontinuation of medication. | — |
Countries
Netherlands
Outcome results
None listed