Deprescribing Levothyroxine in Older Adults

Many older adults take levothyroxine, which is often prescribed inappropriately for those with subclinical hypothyroidism. Levothyroxine contributes to polypharmacy and can cause iatrogenic hyperthyroidism, but evidence on effects of its discontinuation remains limited.

In this open-label study, researchers in the Netherlands enrolled 370 community-dwelling adults aged 60 years of age and older (mean age, 70; 80% female) who were on a stable dose of levothyroxine (≤150 μg/day) for at least a year. At baseline, participants had median thyroid-stimulating hormone (TSH) of 2.2 mIU/l and mean levothyroxine dose of 84 μg/day. They underwent stepwise dose reduction* with monitoring of symptoms and thyroid function.