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Abstract 26: To compare the efficacy and safety of 5 days a week levothyroxine verses daily replacement therapy in hypothyroid patients; experience from a tertiary care centre in Central India

Background: Hypothyroidism is a common endocrine disorder and associated with several complications if not diagnosed and managed. Levothyroxine replacement therapy is the treatment of choice. Traditionally the levothyroxine is given daily empty stomach. Levothyroxine has a long half-life of 6- 7 days and hence can be given 5 days a week keeping the weekly dose same. Aims and Objectives: To compare the efficacy and safety of 5 days a week levothyroxine verses daily replacement therapy in hypothyroid patients and to identify patient's satisfaction level at the end of trial. Methods: Patient diagnosed with hypothyroidism and having stable thyroid function in last 6 months with minimum 2 normal thyroid profile report on same LT4 dose will be shifted to 5 days a week regimen after informed consent. Biochemical analysis for thyroid profile was done at 12 and 24 weeks or SOS according to clinical judgement. Result: 75 Hypothyroid patients were included in the study with male to female ratio of 3:22. The mean age of our patients was 41.6 years. Mean duration of hypothyroidism was 7.6 years. The mean TSH, T4, T3 at baseline was as, 3.12 μIU/ml, 8.6μg/dl, 0.91ng/ml and at 12 weeks and 24 weeks were as 3.72 μIU/ml, 8.1μg/dl, 1.1ng/ml and 3.31 μIU/ml, 8.2μg/dl, 0.83 ng/ml respectively. There was no significant difference in thyroid profile. 63 patients did not require any dose adjustment. In 7 patients dose increment was required while in 5 patients dose reduction was done. 41 patients were more satisfied with 5 days a week, 11 patients were more satisfied with traditional daily dosing while 23 had no preferences and were like just will follow as per treating doctor. Conclusion: 5 days a week levothyroxine replacement regimen is non-Inferior to daily levothyroxine replacement regimen in treating hypothyroid patients.