Hypothyroidism Clinical Trial
Official title:
Effects of Probiotics Assumption on Serum Thyroid Hormone and TSH Levels in Hypothyroid Patients on Levothyroxine Treatment
A prospective, randomized, single-blind, controlled, investigator-started clinical trial was carried out. Patients with primary hypothyroidism were randomly assigned to the study (VSL#3®+ LT4) and the control group (LT4). A two months treatment phase was followed by two months of follow-up. Clinical examination, blood tests for thyroid function and for peripheral tissue markers of thyroid hormones effect were performed monthly for 4 months. LT4 dose adjustments were performed during the study when necessary.
Consecutive patients on LT4 replacement therapy attending the Endocrinology Unit of Modena
(Italy) were screened. According to inclusion and exclusion criteria, eighty participants
were enrolled and randomized in study or control group. The random allocation sequence was
generated using 'Statistical Package for the Social Sciences' software for Macintosh (SPSS)
considering a 1:1 ratio by the statistician of the Unit. Clinicians evaluating and enrolling
patients were blinded to the randomization list. The study design provided a monthly visit
for a 4 months overall time-frame. Patients assigned to the study group took the probiotic
supplement VSL#3® for two months, followed by a two months period of follow-up. Study group
patients were taught to assume the probiotic supplement at least two hours after LT4
administration, to dissolve it in a cold beverage and to store it in a refrigerator (2°-8°C)
in order to preserve bacteria load. The study design was single-blind since only the
clinician was aware of the allocation. The VSL#3® administration was provided by nurses.
Participants were invited to return all used and unused sachets to count the number of
opened sachets per the number of treatment days.
All patients underwent five visits (baseline, visit 1, 2, 3 and 4) in which anthropometrical
evaluation (weight and height) and hormonal function assessment were performed. A blood
sample was taken in the morning at each visit, on empty stomach and before LT4 ingestion. In
occurrence of hormonal alteration, LT4 daily dose was adjusted according to clinical
guidelines. At baseline, visit 2 and visit 4, patients underwent clinical examination with
heart rate and blood pressure evaluation. During each visit, the following data were
collected: probiotic assumption, sex, age, hypothyroidism aetiology, LT4 formulation dose
and brand, body mass index (BMI), body surface area (BSA), systolic blood pressure,
diastolic blood pressure, heart rate, TSH, fT4, fT3 and any possible LT4 posology
adjustment. All the clinical data have been further databased.
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