Hypothyroidism Clinical Trial
Official title:
Levothyroxine Substitution Therapy in Hypothyroid Patients - Impact on Appetite and Food Intake
This project has the following primary aims:
To measure changes in appetite and food intake in newly diagnosed hypothyroid patients during
the first six months after starting levothyroxine (L-T4) substitution therapy
Secondary aims are:
To delineate the effect of L-T4 substitution therapy on thyroid status, body weight, body
mass index (BMI), body composition, physical activity, glycaemic control, postprandial gut
and pancreatic hormone responses, gastric and gall bladder emptying, resting energy
expenditure (REE), quality of life (QOL) and cognitive function
18 newly diagnosed hypothyroid female patients and 18 healthy controls age between 20 and 75
years will be recruited from the out-patients clinic in Herlev and Gentofte Hospital and the
general practitioners before start of substitution therapy.
The study is devided in to three identical experimental days of approx. 6 hours. First
experimental day placed before T4 treatment is initiated. Second day as soon as Thyroid
Stimulating Hormone (TSH) is below 4 milli unit pr liter (mU/l). The Third experimental day
after 6 months of T4 therapy.
For 5-7 days before each experimental day, the participants' physical activity energy
expenditure (PAEE) will be monitored by an Actiheart® pedometer attached to the skin of the
chest.
The last two days before each experimental day, the participants will follow a standardised
diet following World Health Organization guidelines on energy requirements and nutrient
composition according to gender, age and body weight Shortly after diagnosis patients will
undergo a test panel at the first experimental day, where patients arrives fasting.
Visual analog score on satiety and thirst will be filled out continuously. REE will be
measured by a CCM-express calorimeter,
- Dual Energy X-ray absorptiometry (DEXA)-scan
- Blood samples will be taken continuously during the experimental day. Gall bladder size
will be examined at 6 times during the experimental day using ultra sound.
At the end of the day, patients´ satiety will be examined with an ad libitum meal.
Blood will be analysed for Gastric inhibitory polypeptide (GIP), Glucagon-like Peptide 1
(GLP-1), Glucagon-like Peptide 2 (GLP-2), glucagon, peptide tyrosine tyrosine (PYY), Gastrin,
Cholesystokinin (CCK), Insulin, C-peptide, Blood sugar, Cholesterol, Free fatty acids and
paracetamol.
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