Levothyroxine is the standard treatment for hypothyroidism, idealistically prescribed as a fixed daily dose. However, in Thailand and similar settings, the limited availability of tablet strengths makes it difficult to fine-tune doses for individual patients. This often leads to under- or overtreatment. An alternate-dosing regimen, based on total weekly dose, may offer more flexibility and maintain stable thyroid hormone levels. The study aims to evaluate whether this method is as effective and
Conditions
Interventions
- Daily levothyroxine with variable doses (based on available tablet strengths: 50 mcg and 100 mcg).
- Designed to achieve an equivalent total weekly dose.
- Adjustment within +/- 5 % of the calculate
Active Comparator Drug,Active Comparator Drug
Alternate-Dosing Regimen,Fixed-Dosing Regimen
Sponsors
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Inclusion criteria
Inclusion criteria: 1. Age 18-65 years 2. Diagnosed with hypothyroidism 3. Admitted to Ramathibodi Hospital for total thyroidectomy due to a benign condition, or currently receiving levothyroxine therapy for hypothyroidism 4. Requires levothyroxine as thyroid hormone replacement
Exclusion criteria
Exclusion criteria: 1. Pregnant or breastfeeding individuals 2. Presence of uncontrolled medical conditions that could affect thyroid function 3. History of or newly diagnosis of thyroid cancer 4. Known allergy or intolerance to levothyroxine or its components 5. Inability to comply with the study protocol or follow-up requirements 6. Acute illness required hospitalization (unrelated to thyroidectomy) in the last 90 days 7. Diagnosis of liver cirrhosis (any stages) 8. Abnormal liver function tests (AST/ALT > 3 times the upper limit of normal or albumin < 2.5 g/dL) in the last 90 days 9. eGFR < 30 mL/min/1.73 m2 10. Receive levothyroxine 100 mcg/day as initiating dose
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Thyroid stimulating hormone (TSH) 8th and 16th week mIU/L | — |
Secondary
| Measure | Time frame |
|---|---|
| Free thyroxine 4 (FT4) 8th and 16th week ng/dL,Clinical symptoms 8th and 16th week physician assessment,patient satisfactoriness 8th and 16th week patient self assessment,patient preference at the end of trial patient self assessment | — |
Countries
Thailand
Contacts
Public ContactJiradej Tesriprasert
Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Outcome results
None listed