A Case of Refractory Hypothyroidism due to Poor Compliance Treated with the Weekly Intravenous and Oral Levothyroxine Administration
Table 1
Changes in parameters following the intravenous (ivLT4) or oral administration of LT4.
Parameter
before ivLT4
after ivLT4
before oral LT4
after oral LT4
Systolic BP (mmHg)
101
142
125
104
Diastolic BP (mmHg)
67
94
78
67
Heart rate (bpm)
56
76
60
83
WBC (/μL)
3400
4600
5000
5300
Hb (g/dL)
8.0
12.6
12.8
11.1
Ht (%)
25.3
37.7
39.4
35.3
PLT (x10000/μL)
12.8
15.1
17.3
18.5
TP (g/dL)
6.6
6.2
7.2
6.9
Alb (g/dL)
3.7
4.3
3.8
3.3
BUN (mg/dL)
25
15
21
18
CRE (mg/dL)
1.29
0.75
1.07
0.97
UA (mg/dL)
5.0
4.3
5.2
4.9
Na (mEq/L)
141
139
141
139
K (mEq/L)
4.2
3.5
3.5
4.2
Cl (mEq/L)
108
106
108
104
Adjusted Ca (mg/dL)
8.3
9.0
8.9
9.1
IP (mg/dL)
4.4
3.9
3.1
3.3
LDH (U/L)
243
167
214
183
AST (U/L)
33
17
23
21
ALT (U/L)
22
13
18
16
-GTP (U/L)
28
11
14
12
ALP (U/L)
156
175
188
233
TG (mg/dL)
121
53
73
42
HDL-C (mg/dL)
49
78
109
97
LDL-C (mg/dL)
183
108
219
119
CK (IU/L)
206
55
108
64
CRP (mg/dL)
0.14
0.04
0.02
0.07
TSH (μIU/mL)
146.8
69.22
147.4
34.23
FT3 (pg/mL)
<0.26
1.27
0.26
1.4
FT4 (ng/dL)
<0.02
0.58
0.07
0.68
Total T3 (ng/mL)
<10
42
29
63
Total T4 (μg/mL)
<0.3
3.8
1.9
10.0
Tg (ng/dL)
<0.3
N/A
N/A
N/A
TBG (μg/dL)
33.3
N/A
N/A
N/A
Tg Ab (IU/mL)
11 (ref.<28.0)
N/A
N/A
N/A
TPO Ab (IU/mL)
143 (ref.<16.0)
N/A
N/A
N/A
TR Ab (IU/L)
1.0 (ref.<2.0)
N/A
N/A
N/A
TS Ab (%)
149 (ref.<180)
N/A
N/A
N/A
Fe (μg/dL)
58
65
43
31
UIBC (μg/dL)
263
269
292
377
Ferritin (ng/dL)
38
38
8
7
Folic acid (mg/dL)
3.8
N/A
4.5
4.5
Vit.B12 (mg/dL)
N/A
N/A
1500
1500
GH (ng/mL)
1.53
2.67
N/A
1.68
LH (mIU/mL)
4.0
4.3
N/A
11.6
FSH (mIU/mL)
6.0
5.9
N/A
25.4
PRL (ng/mL)
37.8
8.7
N/A
13.0
ACTH (pg/mL)
25.6
13.2
N/A
17.8
Cortisol (μg/dL)
13.3
10.0
N/A
6.8
IGF-I (ng/mL)
32
72
N/A
68
Parameters were evaluated before and 12 months after weekly intravenous LT4 (300 μg) administration (ivLT4) or before and 6 months after weekly oral LT4 (700 μg) administration (oral LT4). N/A: not applicable. ref: cutoff value or negative. Reference range: TSH; 0.4 to 4.0 μU/mL, FT3; 2.36 to 5.00 pg/mL, FT4; 0.88 to 1.67 ng/dL.
