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Original Article
- Thyroid
- Adequate Dose of Levothyroxine for Thyroid-Stimulating Hormone Suppression after Total Thyroidectomy in Patients with Differentiated Thyroid Cancer
- Hyun Jin Ryu, Min Sun Choi, Hyunju Park, Tae Hyuk Kim, Jae Hoon Chung, So Young Park, Sun Wook Kim
- Endocrinol Metab. 2024;39(4):615-621. Published online August 7, 2024
- DOI: https://doi.org/10.3803/EnM.2023.1896
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- 190 Download
- 7 Web of Science
- 6 Crossref
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Abstract
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ePub - Background
The adequate dose of levothyroxine (LT4) for patients who have undergone total thyroidectomy (TT) for differentiated thyroid cancer (DTC) is uncertain. We evaluated the LT4 dose required to achieve mild thyroid-stimulating hormone (TSH) suppression in DTC patients after TT.
Methods
The electronic medical records of patients who underwent TT for DTC and received mild TSH suppression therapy were reviewed. Linear regression analysis was performed to evaluate the association between LT4 dose (μg/kg) and an ordinal group divided by body mass index (BMI). We also evaluated the trend in LT4 doses among groups divided by BMI and age.
Results
In total, 123 patients achieved mild TSH suppression (0.1 to 0.5 mIU/L). The BMI variable was divided into three categories: <23 kg/m2 (n=46), ≥23 and <25 kg/m2 (n=30), and ≥25 kg/m2 (n=47). In the linear regression analysis, BMI was negatively associated with the LT4 dose after adjusting for age and sex (P<0.001). The LT4 doses required to achieve mild TSH suppression based on the BMI categories were 1.86, 1.71, and 1.71 μg/kg, respectively (P for trend <0.001). Further analysis with groups divided by age and BMI revealed that a higher BMI was related to a lower LT4 dose, especially in younger patients aged 20 to 39 (P for trend=0.011).
Conclusion
The study results suggest an appropriate LT4 dose for mild TSH suppression after TT based on body weight in patients with DTC. Considering body weight, BMI, and age in estimating LT4 doses might help to achieve the target TSH level promptly. -
Citations
Citations to this article as recorded by
- A paper-based fluorescent aptasensor utilizing click chemistry strategy for portable detection of thyroid stimulating hormone
Changxin Huangfu, Yanting Duan, Chenyue Zhan, Ruimin Liang, Jiajie Xu, Minghua Ge
Microchemical Journal.2026; 225: 118035. CrossRef - Effects of 131I and TSH suppression therapy on METTL3, METTL14 levels and recurrence in thyroid cancer
Li-Guo Yang
American Journal of Cancer Research.2025; 15(1): 42. CrossRef - Developing a machine learning-based predictive model for levothyroxine dosage estimation in hypothyroid patients: a retrospective study
Tran Thi Ngan, Dang Huong Tra, Ngo Thi Quynh Mai, Hoang Van Dung, Nguyen Van Khai, Pham Van Linh, Nguyen Thi Thu Phuong
Frontiers in Endocrinology.2025;[Epub] CrossRef - Tailoring TSH suppression in differentiated thyroid carcinoma: evidence, controversies, and future directions
Xinxin Song, Xin Zhi, Linxue Qian
Endocrine.2025; 89(1): 1. CrossRef - Risk of Osteoporotic Fractures among Patients with Thyroid Cancer: A Nationwide Population-Based Cohort Study
Eu Jeong Ku, Won Sang Yoo, Yu Been Hwang, Subin Jang, Jooyoung Lee, Shinje Moon, Eun Kyung Lee, Hwa Young Ahn
Endocrinology and Metabolism.2025; 40(2): 225. CrossRef - Levothyroxine Dosing for Thyroid-Stimulating Hormone Suppression in Patients with Differentiated Thyroid Cancer after Total Thyroidectomy
Mijin Kim
Endocrinology and Metabolism.2024; 39(4): 576. CrossRef
- A paper-based fluorescent aptasensor utilizing click chemistry strategy for portable detection of thyroid stimulating hormone
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