Effects of levothyroxine substitution therapy on hunger and food intake in individuals with hypothyroidism
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Effects of levothyroxine substitution therapy on hunger and food intake in individuals with hypothyroidism. / Medici, Bjarke R.; Nygaard, Birte; la Cour, Jeppe L.; Krakauer, Martin; Brønden, Andreas; Sonne, Mette P.; Holst, Jens J.; Rehfeld, Jens F.; Vilsbøll, Tina; Faber, Jens; Knop, Filip K.
In: Endocrine Connections, Vol. 12, No. 10, e230314, 2023.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Effects of levothyroxine substitution therapy on hunger and food intake in individuals with hypothyroidism
AU - Medici, Bjarke R.
AU - Nygaard, Birte
AU - la Cour, Jeppe L.
AU - Krakauer, Martin
AU - Brønden, Andreas
AU - Sonne, Mette P.
AU - Holst, Jens J.
AU - Rehfeld, Jens F.
AU - Vilsbøll, Tina
AU - Faber, Jens
AU - Knop, Filip K.
N1 - Publisher Copyright: © 2023 the author(s). Published by Bioscientifica Ltd.
PY - 2023
Y1 - 2023
N2 - Context: In individuals with hypothyroidism and overweight, levothyroxine substitution therapy is often expected to cause weight loss due to its effect on resting energy expenditure. However, despite levothyroxine-induced enhancement of resting energy expenditure, fat mass loss is rarely seen after levothyroxine substitution therapy. The mechanism behind this conundrum is unknown. Aim: The aim of the study was to assess the effect of levothyroxine therapy on hunger sensations and ad libitum food intake in individuals with hypothyroidism. Design and setting: Prospective cohort study of 18 newly diagnosed hypothyroid women (thyroid-stimulating hormone (TSH) >10 mU/L). Participants were investigated at diagnosis, after normalization of TSH (<4.0 mU/L), and after 6 months of successful treatment. Eighteen age and body mass index-matched healthy controls were also included. Intervention: Hypothyroid individuals were treated with levothyroxine according to European Thyroid Association guidelines. Main outcomes: Changes in hunger sensation were assessed using visual analog scales (cm) before and during a standardized mixed meal test, and food intake was measured during a subsequent ad libitum meal (g). Results: After 6 months of levothyroxine therapy, mean resting energy expenditure was increased by 144 kcal/day (10%) (P < 0.001). Weight loss was comprised of 0.8 kg fat-free mass while fat mass remained unchanged. Fasting hunger sensation increased from a mean of 4.5 (s.d. 2.2) cm to 5.5 (s.d. 2.2) cm (P = 0.047). The numerical increase in ad libitum meal intake did not reach statistical significance. Conclusion: Our data suggest that levothyroxine-induced hunger may be a culprit in the lack of fat mass loss from levothyroxine therapy.
AB - Context: In individuals with hypothyroidism and overweight, levothyroxine substitution therapy is often expected to cause weight loss due to its effect on resting energy expenditure. However, despite levothyroxine-induced enhancement of resting energy expenditure, fat mass loss is rarely seen after levothyroxine substitution therapy. The mechanism behind this conundrum is unknown. Aim: The aim of the study was to assess the effect of levothyroxine therapy on hunger sensations and ad libitum food intake in individuals with hypothyroidism. Design and setting: Prospective cohort study of 18 newly diagnosed hypothyroid women (thyroid-stimulating hormone (TSH) >10 mU/L). Participants were investigated at diagnosis, after normalization of TSH (<4.0 mU/L), and after 6 months of successful treatment. Eighteen age and body mass index-matched healthy controls were also included. Intervention: Hypothyroid individuals were treated with levothyroxine according to European Thyroid Association guidelines. Main outcomes: Changes in hunger sensation were assessed using visual analog scales (cm) before and during a standardized mixed meal test, and food intake was measured during a subsequent ad libitum meal (g). Results: After 6 months of levothyroxine therapy, mean resting energy expenditure was increased by 144 kcal/day (10%) (P < 0.001). Weight loss was comprised of 0.8 kg fat-free mass while fat mass remained unchanged. Fasting hunger sensation increased from a mean of 4.5 (s.d. 2.2) cm to 5.5 (s.d. 2.2) cm (P = 0.047). The numerical increase in ad libitum meal intake did not reach statistical significance. Conclusion: Our data suggest that levothyroxine-induced hunger may be a culprit in the lack of fat mass loss from levothyroxine therapy.
KW - body composition
KW - food intake
KW - hunger
KW - hypothyroidism
KW - levothyroxine
U2 - 10.1530/EC-23-0314
DO - 10.1530/EC-23-0314
M3 - Journal article
C2 - 37582332
AN - SCOPUS:85172665589
VL - 12
JO - Endocrine Connections
JF - Endocrine Connections
SN - 2049-3614
IS - 10
M1 - e230314
ER -
ID: 369124953