GAMBARAN PENGOBATAN LEVOTIROKSIN PADA PENDERITA HIPOTIROID SUBKLINIS DI KLINIK LITBANG GAKI MAGELANG

Abstract

There are clinicians who agree with treatment of subclinical hypothyroidism but others are disagree. A few of subclinical hypothyroid patient without regular thyroxine or iodine treatment will turn into clinical hypothyroidism. Objective. This study aimed to determine the levothyroxine intervention thyroid status in subclinical hypothyroidism patients, especially comparing the Thyroid Stimulating Hormone (TSH) dan free tetraiodotironine (fT4) level after 50 µg per day dose of levotiroksin intervention. Method. This is an experimental study using randomized double blind controlled trial design. The respondents were goiter patients with subclinical hypothyroidism in Litbang GAKI clinic who fulfill inclusion criterias (TSH ≥2.5 μIU/mL and FT4 0.8 - 2.0 µIU/mL). There were 57 peoples divided into two groups: 28 peoples given 50 µg dose of levotiroksin intervention and 29 people given placebo. Data were analyzed using Anova test. Results. The delta mean of TSH level in the first month of study decreased by 3.2 µIU/mL in the intervention group and 0.96 µIU/mL in the placebo groups with p value=0.003. At two months, the TSH level decreased by 4.1 µIU/mL in intervention group and 1.5 µIU/mL in the placebo group with p value=0.001. The fT4 level was not decreased in the first month intervention with p value=0.054, the delta mean was 0.23 µIU/mL in the intervention group and 0.02 µIU/mL in placebo groups, while in the second month, the delta mean of fT4 level increased by 0.4 µIU/mL in the intervention group and 0.06 µIU/mL in the placebo group with p value=0.008. Conclusion. The 50 µg per day dose of levothyroxine intervention could improve the fT4 level in the second month of intervention, tailored to decreased levels of TSH in the 1st intervention.