Discontinuation of Levothyroxine Therapy for Patients With Subclinical Hypothyroidism

• Status: Recruiting
• Trial end date: 2022-12-31
• Target enrollment: 0
• Participant gender: All

Summary

The investigators propose the following hypothesis: discontinuation of levothyroxine (LT4) for veterans with subclinical hypothyroidism (SCH) will be feasible, acceptable, and safe and will not negatively affect their Quality of Life (QoL). The investigators aim to 1) evaluate the feasibility of LT4 discontinuation among veterans with SCH and determine the changes in QoL measures, lipids, and adverse events, and 2) assess the acceptability of LT4 discontinuation among veterans with SCH and LT4 prescribing clinicians.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Central Arkansas Veterans Healthcare System; VA Office of Research and Development
• Collaborator: Central Arkansas Veterans Healthcare System

Criteria

Inclusion Criteria:

• Veterans

• diagnosis of SCH between January 1, 2009 and December 31, 2019, at the Central Arkansas Veterans Healthcare System (CAVHS)

Exclusion Criteria:

• TSH > 10 mlU/L (at any point)

• LT4 dose more than 75 mcg daily

• use of antithyroid medications, amiodarone, tyrosine kinase inhibitors or lithium

• history of thyroidectomy or radioactive iodine therapy

• LT4 suppressive therapy for thyroid cancer, goiter, or inflammation

• pregnancy or plans for pregnancy in the next 6 months

• an unstable medical condition that would jeopardize safety or interfere with study participation

• severe hypothyroidism-related symptoms

• strong family history of hypothyroidism

• severe dyslipidemia

• hospitalization for major illness within the previous 4 weeks

• acute coronary artery syndrome, acute myocarditis, or pancarditis with the previous 12 months

• grade IV New York Heart Association heart failure

• receiving services from hospice

• lack of decision-making capacity

• terminal medical condition for which life expectancy would be less than 6 months

• not willing to stop LT4

• self-reported non-adherence to LT4 therapy

• abnormal TSH at time of screening for participation (assessed during Baseline Visit)