No Effect of Levothyroxine on Hemoglobin in Older Adults With Subclinical Hypothyroidism: Pooled Results From 2 Randomized Controlled Trials

Research output: Contribution to journalJournal articleResearchpeer-review


  • Fulltext

    Final published version, 557 KB, PDF document

  • Robert S. Du Puy
  • Rosalinde K. E. Poortvliet
  • Simon P. Mooijaart
  • David J. Stott
  • Terry Quinn
  • Naveed Sattar
  • Westendorp, Rudi GJ
  • Patricia M. Kearney
  • Vera J. C. McCarthy
  • Stephen Byrne
  • Nicolas Rodondi
  • Oliver Baretella
  • Tinh-Hai Collet
  • Diana van Heemst
  • Olaf M. Dekkers
  • J. Wouter Jukema
  • Johannes W. A. Smit
  • Jacobijn Gussekloo
  • Wendy P. J. den Elzen

Context Subclinical thyroid dysfunction and anemia are common disorders, and both have increasing prevalence with advancing age. Objective The aim of this study was to assess whether levothyroxine treatment leads to a rise in hemoglobin levels in older persons with subclinical hypothyroidism. Methods This preplanned combined analysis of 2 randomized controlled trials included community-dwelling persons aged 65 years and older with subclinical hypothyroidism who were randomly assigned to levothyroxine or placebo treatment. The levothyroxine dose was periodically titrated aiming at thyroid stimulating hormone (TSH) level within the reference range, with mock titrations in the placebo group. The main outcome measure was the change in hemoglobin level after 12 months. Results Analyses included 669 participants (placebo n = 337, levothyroxine n = 332) with a median age of 75 years (range, 65-97) and mean baseline hemoglobin of 13.8 +/- 1.3 g/dL. Although levothyroxine treatment resulted in a reduction in TSH from baseline after 12 months of follow-up compared with placebo, the change in hemoglobin level was not different between the levothyroxine and the placebo groups (-0.03 g/dL [95% CI, -0.16 to 0.11]). Similar results were found in stratified analyses including sex, age, or TSH levels. No difference in change of hemoglobin levels after 12 months was identified in 69 participants with anemia at baseline (-0.33 g/dL [95% CI, -0.87 to 0.21]). Conclusion In persons aged 65 years and older with subclinical hypothyroidism, treatment with levothyroxine does not lead to a rise in hemoglobin levels, regardless of the presence of anemia.

Original languageEnglish
JournalJournal of Clinical Endocrinology & Metabolism
Pages (from-to)e2339–e2347
Number of pages9
Publication statusPublished - 2022

    Research areas

  • thyroid, anemia, RCT, subclinical hypothyroidism, older adults, THYROID-DYSFUNCTION, ANEMIA, ERYTHROPOIESIS, HORMONES, RISK

ID: 301626802