LT3 Plus LT4 Therapy Raises Psychiatric Risk 43% in 184,266 Hypothyroidism Patients
Updated
Updated · Medscape · May 18
LT3 Plus LT4 Therapy Raises Psychiatric Risk 43% in 184,266 Hypothyroidism Patients
1 articles · Updated · Medscape · May 18
A Swedish cohort study found autoimmune hypothyroidism patients starting liothyronine plus levothyroxine faced a 43% higher risk of any psychiatric morbidity than those staying on levothyroxine alone.
The signal extended across specific outcomes: affective or anxiety morbidity rose 44%, and psychotic morbidity 46%, after median follow-up of 2.7 years in the combination-therapy group.
Among 184,266 adults without prior psychiatric morbidity, 5,346 received LT3 plus LT4 and 178,920 remained on LT4 only; the association held in both sexes and in patients younger than 75.
Women on combination therapy had higher psychotic-morbidity risk, and patients younger than 30 showed the strongest increase, with an adjusted hazard ratio of 1.91.
The authors said the findings do not prove causation because LT3 may be started in patients already developing poor mental well-being, and the retrospective design left room for confounding and surveillance bias.
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