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Is weekly levothyroxine as effective as daily therapy in patients with hypothyroidism?

Is weekly levothyroxine as effective as daily therapy in patients with hypothyroidism?

Once-weekly levothyroxine (LT4) therapy is an effective alternative for patients with hypothyroidism compared with daily therapy, especially for those who have compliance issues, finds research published in the European Thyroid Journal.

Dr Rajput R and associates in a  randomised, cross-over study, compared the effects of daily vs weekly LT4 alternative on thyroid function test (TFT) and quality of life (QoL) in patients with hypothyroidism.

In the study a total of 100 hypothyroid patients on a stable LT4 dose were divided into 2 groups of 50 each. In group I, patients were given daily therapy for 6 weeks and then shifted to weekly therapy for the next 6 weeks. In group II, patients were given LT4 once a week for 6 weeks and then switched to daily therapy for the next 6 weeks. TFT, quality of life (QOL), and hyperthyroidism symptom scale (HSS) score of patients were compared in each group at 0, 6, and 12 weeks.
The results showed that TFT remained within the normal range, but TSH increased (group I, daily 2.8 ± 1.4 mIU/L, weekly 3.9 ± 1.1 mIU/L, p = 0.001; group II, weekly 4.6 ± 1.1 mIU/L, daily 2.7 ± 1.2 mIU/L, p = <0.001) and T3/T4 decreased with weekly therapy as compared to daily therapy. No significant difference in HSS score was found between daily and weekly administration of LT4. With weekly therapy, QOL showed improvement in bodily pain, vitality, mental health, and social functioning.
The researchers concluded that Once-weekly LT4 administration is a reasonable alternative for patients, especially for those who have issues with compliance.“Our study shows that in today’s era of busy and hectic schedules where it is difficult for patients to take LT4 following a rigid schedule, once weekly LT4 administration provides an alternative approach for the treatment of hypothyroidism, especially in patients where compliance is a major issue,” the authors said.

For further reference log on to :

Rajput R, Pathak V. The Effect of Daily versus Weekly Levothyroxine Replacement on Thyroid Function Test in Hypothyroid Patients at a Tertiary Care Centre in Haryana. Eur Thyroid J. 2017;6(5):250-254. doi: 10.1159/000477348. PMID: 29071237

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  1. I came across a patient who was converted to weekly therapy instead of daily therapy. Her symptoms increased and TSH was also significantly higher which was previously under control. I still have doubts over weekly therapy. Not comfortable to advise for my patients.