Early effects of LT3 + LT4 combination therapy on quality of life in hypothyroid patients: a randomized, double-blind, parallel-group comparison trial

Abstract Background This study aimed to evaluate the impact of combined levothyroxine (LT4) and triiodothyronine (LT3) therapy on quality of life in patients with primary hypothyroidism. Methods In a randomized, double-blind, parallel-group trial, 151 Iranian patients diagnosed with primary hypothyr...

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Main Authors: Fatemeh Hajtalebi, Fariba Alaei-Shahmiri, Fatemeh Golgiri, Najmeh Shahini, Hamideh Akbari, Kasra Assadian, Seyedarad Mosalamiaghili
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Endocrine Disorders
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Online Access:https://doi.org/10.1186/s12902-025-01840-4
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author Fatemeh Hajtalebi
Fariba Alaei-Shahmiri
Fatemeh Golgiri
Najmeh Shahini
Hamideh Akbari
Kasra Assadian
Seyedarad Mosalamiaghili
author_facet Fatemeh Hajtalebi
Fariba Alaei-Shahmiri
Fatemeh Golgiri
Najmeh Shahini
Hamideh Akbari
Kasra Assadian
Seyedarad Mosalamiaghili
author_sort Fatemeh Hajtalebi
collection DOAJ
description Abstract Background This study aimed to evaluate the impact of combined levothyroxine (LT4) and triiodothyronine (LT3) therapy on quality of life in patients with primary hypothyroidism. Methods In a randomized, double-blind, parallel-group trial, 151 Iranian patients diagnosed with primary hypothyroidism between 2020 and 2021 were enrolled. One group received LT4 alone (n = 80), while the other received LT4 and LT3 (n = 71) for a minimum of six months. The primary outcome was quality of life assessed using the SF-36V1 questionnaire, and the secondary endpoints included clinical and laboratory measurements. Results In the LT4 + LT3 group, a significant reduction in TSH levels (p < 0.05) was observed compared to baseline. While no significant differences emerged between the groups in terms of blood pressure, lipid profiles (except for low-density lipoprotein cholesterol), or body weight, there were notable improvements in physical functioning and bodily pain in the LT4 + LT3 group compared to the LT4 + placebo group. Compared with baseline, combination therapy significantly increased the physical component summary score after six months, but the difference was not significant. Conclusion Combination therapy may benefit patients with primary hypothyroidism, particularly those experiencing body pain or physical function issues. However, the overall impact on quality of life remains inconclusive, as evidenced by the scores for the mental component. Further research is needed to determine the broader implications of this therapy. This study provides valuable insights into the potential advantages of combining LT4 and LT3 in the management of primary hypothyroidism. Trial registration The study was registered with the Iranian Registry of Clinical Trials (IRCT) and assigned the registration number IRCT20200410047012N1 on 2022–08-07. Trial registration number: IRCT20200410047012N1. Date of registration: 2020–06-12.
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spelling doaj-art-e368d1c3f3ea42b3bb54604e66fa4f852025-01-26T12:37:37ZengBMCBMC Endocrine Disorders1472-68232025-01-012511910.1186/s12902-025-01840-4Early effects of LT3 + LT4 combination therapy on quality of life in hypothyroid patients: a randomized, double-blind, parallel-group comparison trialFatemeh Hajtalebi0Fariba Alaei-Shahmiri1Fatemeh Golgiri2Najmeh Shahini3Hamideh Akbari4Kasra Assadian5Seyedarad Mosalamiaghili6Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Golestan University of Medical SciencesEndocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS)Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS)Clinical Research Development Unit (CRDU), Agh ghala Hospital, Golestan University of Medical SciencesClinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Golestan University of Medical SciencesStudent Research Committee, Shiraz University of Medical SciencesStudent Research Committee, Shiraz University of Medical SciencesAbstract Background This study aimed to evaluate the impact of combined levothyroxine (LT4) and triiodothyronine (LT3) therapy on quality of life in patients with primary hypothyroidism. Methods In a randomized, double-blind, parallel-group trial, 151 Iranian patients diagnosed with primary hypothyroidism between 2020 and 2021 were enrolled. One group received LT4 alone (n = 80), while the other received LT4 and LT3 (n = 71) for a minimum of six months. The primary outcome was quality of life assessed using the SF-36V1 questionnaire, and the secondary endpoints included clinical and laboratory measurements. Results In the LT4 + LT3 group, a significant reduction in TSH levels (p < 0.05) was observed compared to baseline. While no significant differences emerged between the groups in terms of blood pressure, lipid profiles (except for low-density lipoprotein cholesterol), or body weight, there were notable improvements in physical functioning and bodily pain in the LT4 + LT3 group compared to the LT4 + placebo group. Compared with baseline, combination therapy significantly increased the physical component summary score after six months, but the difference was not significant. Conclusion Combination therapy may benefit patients with primary hypothyroidism, particularly those experiencing body pain or physical function issues. However, the overall impact on quality of life remains inconclusive, as evidenced by the scores for the mental component. Further research is needed to determine the broader implications of this therapy. This study provides valuable insights into the potential advantages of combining LT4 and LT3 in the management of primary hypothyroidism. Trial registration The study was registered with the Iranian Registry of Clinical Trials (IRCT) and assigned the registration number IRCT20200410047012N1 on 2022–08-07. Trial registration number: IRCT20200410047012N1. Date of registration: 2020–06-12.https://doi.org/10.1186/s12902-025-01840-4HypothyroidismLevothyroxineTriiodothyronineCombination therapyQuality of life
spellingShingle Fatemeh Hajtalebi
Fariba Alaei-Shahmiri
Fatemeh Golgiri
Najmeh Shahini
Hamideh Akbari
Kasra Assadian
Seyedarad Mosalamiaghili
Early effects of LT3 + LT4 combination therapy on quality of life in hypothyroid patients: a randomized, double-blind, parallel-group comparison trial
BMC Endocrine Disorders
Hypothyroidism
Levothyroxine
Triiodothyronine
Combination therapy
Quality of life
title Early effects of LT3 + LT4 combination therapy on quality of life in hypothyroid patients: a randomized, double-blind, parallel-group comparison trial
title_full Early effects of LT3 + LT4 combination therapy on quality of life in hypothyroid patients: a randomized, double-blind, parallel-group comparison trial
title_fullStr Early effects of LT3 + LT4 combination therapy on quality of life in hypothyroid patients: a randomized, double-blind, parallel-group comparison trial
title_full_unstemmed Early effects of LT3 + LT4 combination therapy on quality of life in hypothyroid patients: a randomized, double-blind, parallel-group comparison trial
title_short Early effects of LT3 + LT4 combination therapy on quality of life in hypothyroid patients: a randomized, double-blind, parallel-group comparison trial
title_sort early effects of lt3 lt4 combination therapy on quality of life in hypothyroid patients a randomized double blind parallel group comparison trial
topic Hypothyroidism
Levothyroxine
Triiodothyronine
Combination therapy
Quality of life
url https://doi.org/10.1186/s12902-025-01840-4
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