• Korean Journal of Clinical Pharmacy
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• v.30 no.2
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• pp.87-91
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• 2020

Background: Levothyroxine is an essential drug for the treatment of hypothyroidism or related diseases. Several studies have reported an association between the effects of levothyroxine treatment and time of administration, which can be inconsistent. Objective: This study was conducted to compare the levels of thyroid-stimulating hormone or free thyroxine between morning and nighttime dosing of levothyroxine. Methods: We reviewed previously reported relevant articles and conducted a meta-analysis. Results: In total, five studies were included in this meta-analysis. Results showed that thyroid-stimulating hormone (standard difference in means [SE]=0.321; 95% confidence interval [CI], -0.016 to 0.657) and free thyroxine (SE= -1.367; 95% CI, -2.943 to 0.210) levels did not differ significantly between morning (before breakfast) and nighttime (before bedtime) administration. Conclusion: This is the first meta-analysis to evaluate the effects of time of administration on levothyroxine levels in patients with hypothyroidism. Based on our results, we suggest considering patients' lifestyles or daily routines when counselling them on the optimal time of administration for levothyroxine.

• Journal of Preventive Medicine and Public Health
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• v.47 no.1
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• pp.36-46
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• 2014

Objectives: To evaluate the association between fracture risk and levothyroxine use in elderly women with hypothyroidism, according to previous osteoporosis history. Methods: We conducted a cohort study from the Korean Health Insurance Review and Assessment Service claims database from January 2005 to June 2006. The study population comprised women aged ${\geq}65$ years who had been diagnosed with hypothyroidism and prescribed levothyroxine monotherapy. We excluded patients who met any of the following criteria: previous fracture history, hyperthyroidism, thyroid cancer, or pituitary disorder; low levothyroxine adherence; or a follow-up period <90 days. We categorized the daily levothyroxine doses into 4 groups: ${\leq}50{\mu}g/d$, 51 to $100{\mu}g/d$, 101 to $150{\mu}g/d$, and > $150{\mu}g/d$. The hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated with the Cox proportional hazard model, and subgroup analyses were performed according to the osteoporosis history and osteoporosis-specific drug prescription status. Results: Among 11 155 cohort participants, 35.6% had previous histories of osteoporosis. The adjusted HR of fracture for the > $150{\mu}g/d$ group, compared with the 51 to $100{\mu}g/d$ group, was 1.56 (95% CI, 1.03 to 2.37) in osteoporosis subgroup. In the highly probable osteoporosis subgroup, restricted to patients who were concurrently prescribed osteoporosis-specific drugs, the adjusted HR of fracture for the > $150{\mu}g/d$ group, compared with the 51 to 100 ${\mu}g/d$ group, was 1.93 (95% CI, 1.14 to 3.26). Conclusions: While further studies are needed, physicians should be concerned about potential levothyroxine overtreatment in elderly osteoporosis patients.

• The Journal of Internal Korean Medicine
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• v.28 no.1
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• pp.124-132
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• 2007

Objective : This study was to elucidate the effects of Hyunsamkabhangbang (HSK) on the hyperthyroidism induced by sodium levothyroxine. Method : Sprague-Dawley rats were separated into five groups. Except the normal group, the other four groups were treated with sodium levothyroxine 160${\mu}g/kg/day$ for 5 days by oral administration. Among the four groups, all except one (as control) were treated with various concentrations of HSK (0.5, 1.0, 2.0 g/kg/days) for 3 days separately. T3-uptake, T3, T4, TSH, total cholesterol, free fatty acid, ${\beta}$-lipoprotein, glucose, ALP, AST, ALT change in the serum and body weight of rats were measured after medication of solid extract of HSK. Results : HSK decreased significantly serum T3, T4, T3-uptake, ALP, free fatty acid and glucose level in a dose-dependent manner compared with control. HSK increased significantly serum TSH and total cholesterol level and body weight in a dose-dependent manner compared with control. HSK also increased serum ${\beta}$-lipoprotein level compared with control, but not statistically meaningfully. HSK increased significantly serum AST and ALT level compared with control, but relationship to hyperthyroidism is not found. Conclusions : From these results, it could be concluded that HSK lowers excess thyroid hormone and increased metabolism, resulting in improvement of hyperthyroid state.

• Journal of Sasang Constitutional Medicine
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• v.28 no.2
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• pp.132-146
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• 2016

Objectives This study's object was to observe the comparative effects of Yangkyuksanhwa-tang, Palmulgunja-tang and Cheongpyesagan-tang on the chronic LT4(levothyroxine) induced hyperthyroidism in rats.Methods Six groups, each of 8 rats in group, were used in this study. Saline and distilled water treated rats are intact control group. Hyperthyroidism was induced by daily subcutaneous LT4 300 μg/kg treatment for 27 days(LT4 control). Since 12th LT4 treatment PTU(propylthiouracil) 10 mg/kg was intraperitoneal injected(PTU group) and aqueous extracts of Yangkyuksanhwa-tang, Palmulgunja-tang and Cheongpyesagan-tang(YS, PG and CS) 500 mg/kg were orally administrated(YS, PG, CS group), once a day for 15 days. The differences in the body, thyroid gland and epididymal fat pad weights, serum T3(tri-iodothyronine), T4(thyroxine), TSH(thyroid-stimulating hormone), thyroid gland and epididymal fat pad histopathology, liver weight, AST(asparte aminotransferase), ALT(alanine aminotransferase) concentrations, hepatic lipid peroxidation, GSH(glutathione), SOD(superoxide dismutase), CAT(catalase) activities, liver histopathology were observed to evaluate effects on hyperthyroidism, liver damages and antioxidant effects.Results As results of LT4 treatment, hyperthyroidism and related liver damages such as lower body, thyroid weights, higher serum T3, T4, AST, ALT levels, thinner follicular lining epithelium in thyroid glands were observed. However, these symptoms were inhibited by oral treatment of YS, PG and CS. As compared with PTU treatment, these herbal prescriptions showed lower overall efficacy on the hyperthyroidism, but YS showed more favorable effects on the hepatic antioxidant defense systems.Conclusions This results suggest that YS, PG and CS favorably control the LT4 induced hyperthyroidism and related liver damages in rats through modulation of the hepatic antioxidative defense systems.

• KSBB Journal
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• v.25 no.5
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• pp.449-452
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• 2010

L-Thyroxine possessing a chiral center, the naturally occurring thyroid hormone has been used for the treatment of thyroid dysfunctions and marketed as levothyroxine (L-thyroxine) sodium salt. In this study, after extraction of levothyroxine tablet as a pre-treatment process, direct enantiomer separation of thyroxine on crown ether derived chiral columns for determination of optical purity was performed using reversed mobile phase with acid additive. The chromatographic method developed in this study was applied in the determination of optical purity of several current domestic and foreign commercialized levothyroxine tablets. Optical purity values of these commercialized L-thyroxine sodium tablets except one were higher than 99 percents.

• The Korea Journal of Herbology
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• v.21 no.4
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• pp.19-25
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• 2006

Objectives : The aim was to study experimentally the effects of KABHANG-BANG(갑항방) on the hyperthyroidism of rats induced by sodium levothyroxine. Methods : Spargue-Dawley rats were separated into four groups. Except normal group, the other three groups were treated with sodium levothyroxine $32{\mu}g$/200g/days for 5 days by oral administration. Among the three groups, two except one(as control) were treated KHB extract 225mg/200g/days(sample A), 450mg/200g/days(sample B) for 3 days separately. T3-uptake, T3, T4, r-TSH, total cholesterol, total protein change in the Serum of rats were measured after medication of solid extract of KHB. Results : As a result of this study, in the serum T3 and T4 level were decreased in sample A and B compared to controls. The serum r-TSH, total cholesterol and total protein were increase in sample A and B compared to controls. In the serum T3-uptake content, Smple B showed significant decrease in comparison with control group, but Sample A did not show significant decrease. Conclusion : According to the above results, it is suggested that KHB is effective to cure hyperthyroidism.

• Korean Journal of Veterinary Service
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• v.35 no.2
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• pp.159-163
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• 2012

A 4-year-old female Cocker spaniel weighing 7.74 kg was presented with a seven-month history of lethargy and skin problems. On the basis of clinical history, physical examination, laboratory tests, electrocardiogram, radiography, ultrasonography, and thyroid function tests, the dog was diagnosed as hypothyroidism. The dog was administered levothyroxine and presented a good response to the therapy. However, uncontrolled for about 6 months, the dog was re-admitted to hospital with depression and three seizure episodes. The dog was diagnosed as hypothyroidism with concurrent myxedema coma and gallbladder mucocele. With fluid therapy and administration of levothyroxine, the dog was successfully controlled for 3 months after starting treatment. This report describes the clinical features and successful treatment of a Cocker spaniel dog with concurrent hypothyroidism and myxedema coma.

• The Korea Journal of Herbology
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• v.21 no.4
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• pp.11-17
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• 2006

Objectives : The aim was to study experimentally the effects of YUKWOOLTANG(li${\`{u}}$y${\`{u}}$-t${\={a}}$ng; YWT) induced by sodium levothyroxine. Methods : Spargue-Dawley rats were separated into four groups. Except normal group, the other three groups were treated with sodium levothyroxine $32{\mu}g$/200g for 5 days. Among the three groups, two except one(as control group) were treated YWT extract separately(sample A:75mg/200 g, sample B: 150mg/200 g ). T3-uptake, T3, T4, r-TSH, total cholesterol, total protein change in the serum of rats were measured after medication of solid extract of YWT. Results : As a result of this study, in the serum T3-uptake content, sample A showed significant decrease in comparison with control group, but sample B group did not show significant decrease. 2. In the serum T3 content, sample B showed significant decrease in comparison with control group. In the serum T4 content, YWT showed significant decrease in comparison with control group. The serum r-TSH was shown with valuable increase in sample B of YWT. The serum total cholesterol was not shown with valuable increase in YWT. The serum total protein was shown with valuable increase in YWT. Conclusion : These results suggest that YWT is effective to cure Hyperthyroidism.

• The Journal of Korean Medicine
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• v.27 no.3 s.67
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• pp.178-186
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• 2006

Objective: The aim was to study experimentally the effects of Radix Scrophulariae (玄蔘) induced by Sodium levothyroxine. Methods: Sprague-Dawley rats Were separated into four groups. Except for the normal group, the other three were treated with sodium levothyroxine $160{\mu}g/kg$ for 5 days. Among the three groups, two (except the control) were treated with Radix Scrophulariae extract 0.5g/kg (HNS 1) or 1.0g/kg (HNS II). $T_3-uptake,\;T_3,\;T_4$, TSH, total cholesterol, glucose, ALP, AST, ALT, free fatty acid, $\beta-lipoprotein$, and change in the serum of rats were measured after medication of solid extract of Radix Scrophulariae. Results: As a result of this study, HNS II showed significant decrease in comparison with the control in the serum $T_3-uptake,\;T_3$ ALP and free fatty acid content. HNS I and HNS II showed significant decrease in comparison with the control in the serum of $T_4$ and glucose content. HNS I and HNS II showed significant increase in comparison with the control in the serum of TSH and total cholesterol content. In body weight, HNS I and HNS II showed significant increase in comparison with the control. Conclusion: These results suggest that Radix Scrophulariae is effective to cure hyperthyroidism.

• The Journal of Korean Medicine
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• v.27 no.3 s.67
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• pp.169-177
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• 2006

Objective: The aim was to study experimentally the effects of Dioscorea bulbifera L. induced by sodium levothyroxine. Methods: Sprague-Dawley rats were separated into four groups. Except for the normal group, the other three were treated with sodium levothyroxine $160{\mu}g/kg$ for 5 days. Among the three groups, two (except the control) were treated with Dioscorea bulbifera L. extract of 0.75g/kg (sample A) or 1.5g/kg (sample B). $T_3-uptake,\;T_3,\;T_4$, TSH, total cholesterol, glucose, ALP, AST, ALT, tree fatty acids, $\beta-lipoprotein$, and change in the serum of rats were measured after medication with solid extract of Radix Scrophulariae. Results: $T_4$ concentration and $T_3-uptake$ level decreased in sample A and B compared to controls. $T_3$ concentration decreased but not statistically meaningful. Considering lipid metabolism, only free fatty acid level was significantly reduced glucose level also significantly decreased in sample B. Serum AST, ALT and ALP levels were slightly elevated but there was no meaning statistically, which doesn't mean Dioscorea bulbifera L. has liver toxicity because the quantity of the extract perhaps couldn't reach the minimal dose causing liver toxicity, which according to an article was 60g. Body weight significantly increased in comparison to controls. Conclusion: These results suggest that Dioscorea bulbiftra L. lowers excess thyroid hormone and increased metabolism, resulting in improvement of hyperthyroid state.