History
# Registration date Revision Id
5 2022-07-31, 1401/05/09 235826
4 2022-07-12, 1401/04/21 233342
3 2022-06-30, 1401/04/09 232804
2 2022-02-01, 1400/11/12 215679
1 2020-06-12, 1399/03/23 138515
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  • Protocol summary

    1.Comparison of mean body weight in hypothyroid patients in the combination therapy and placebo group. 2. Comparison of mean physical_mental disorders score in hypothyroid patients in the combination therapy and placebo group. 3.Comparison of mean score of psychological field in hypothyroid patients in combination therapy and placebo group. 4.Comparison of mean social dysfunction score in hypothyroid patients in the combination therapy and placebo group. 5.Comparison of mean environmental mental disorder score in hypothyroid patients in the combination therapy and placebo group. 6. .comparison of mean physical activity score in hypothyroid patients in the combination therapy and placebo group.
    the present RCT will be conducted to evaluate the effect of combined LT4+LT3 therapy vs LT4 alone on the quality of life.
    مقایسه میانگین وزن بیماران هیپوتیروئید در گروه درمان ترکیبی و پلاسبو. مقایسه میانگین نمره حیطه جسمانی اختلال روانی در بیماران هیپوتیروئید در گروه درمان ترکیبی و پلاسبو. مقایسه میانگین نمره حیطه روانشناختی در بیماران هیپوتیروئید در گروه درمان ترکیبی و پلاسبو . مقایسه میانگین نمره اختلال عملکرد اجتماعی در بیماران هیپوتیروئید در گروه درمان ترکیبی و پلاسبو . مقایسه میانگین نمره حیطه محیطی اختلال روانی در بیماران هیپوتیروئید در گروه درمان ترکیبی و پلاسبو. مقایسه میانگین نمره فعالیت بدنی در بیماران هیپوتیروئید در گروه درمان ترکیبی و پلاسبو.
    RCT حاضر برای ارزیابی اثر درمان ترکیبی LT4 + LT3 (در مقابل LT4 به تنهایی) بر کیفیت زندگی انجام خواهد شد.
    Randomized,double-blind,parallel-group study on 158 patients Block randomization will be used.
    A randomized, double-blind, parallel-group comparison trial in a 1:1 ratio including the baseline (April- Oct 2020 ) and the 6-months follow-up
    کارآزکایی بالینی دو گروهه، با گروههای موازی، دوسویه کور، تصادفی شده، فاز 3 بر روی 158 بیمار، برای تصادفی سازی از نرم افزار block randomization استفاده خواهد شد
    یک کارآزمایی مقایسه تصادفی، دوسوکور، گروه موازی در نسبت 1:1 شامل ویزیت پایه (آوریل تا اکتبر 2020) و پیگیری 6 ماهه
    Hypothyroid patients with levothyroxine monotherapy and normal TSH In this double blind study, patients divided in two groups and received their regimens by health workers. Place of study: Sayad Shirazi Hospital Endocrinology Clinic, Gorgan
    Hypothyroid patients with levothyroxine monotherapy and normal TSH In this double blind study, patients divided in two groups Place of study: Sayad Shirazi Hospital Endocrinology Clinic, Gorgan
    بیماران هیپوتیروئید که تحت درمان لووتیروکسین به تنهایی قرار دارند و از لحاظ بیوکمیکال یوتیروئید شده اند، پس از اعمال معیارهای ورود بیماران دو گروه شده و درمان ها را دریافت می کنند.کورسازی دوطرفه بطوریکه محقق و بیمار از نوع درمان اطلاعی ندارد و دارو توسط مراقبین سلامت به بیمار داده می شود محل انجام مطالعه: کلینیک غدد بیمارستان صیاد شیرازی گرگان
    بیماران هیپوتیروئیدبا TSH نرمال که تحت درمان لووتیروکسین به تنهایی قرار دارند ، بصورت کورسازی دوطرفه بیماران دو گروه شده تقسیم می شوند محل انجام مطالعه: کلینیک غدد بیمارستان صیاد شیرازی گرگان
    1.Age > 16 years old 2.History of hypothyroidism more than 6 months 3.Regular use and fixed dose of the drug for 3 months 4.Symptoms of hypothyroidism with normal tests 5.The score above100 according to the SF36 General Health Standard Questionnaire
    Inclusion Criteria Age over 16 years Being able to read and understand Persian Diagnosis of overt hypothyroidism at least 6 months before inclusion Stable and regular LT4 monotherapy for at least 3 months before inclusion Patient-reported signs and symptoms of hypothyroidism including fatigue, mood change, weight gain, lethargy, decreased psychomotor performance conative, depression, and disturbances despite normal thyroid hormone levels Exclusion criteria Pregnancy or planned pregnancy within the next 6 months Patients with drug or alcohol addiction Patients with Malignancy, cardiovascular disease ,renal, or hepatic disease, chronic liver disease ,depression, anxiety Patients with mental illness and had been on psychiatric medicine for 6 months before inclusion
    سن بالای 16 سال و سابقه >6 ماه از تشخیص هایپوتیروئیدی حداقل 6 ماه از تشخیص هیپوتیروئیدی آنها گذشته است. مصرف منظم دارو و ثابت ماندن دوز دارو برای 3 ماه وجود علایم هایپوتیروئیدی با آزمایشات نرمال نمره بالای 100 بر اساس پرسشنامه استاندارد سلامت عمومی SF36
    معیارهای ورود: - سن بالای 16 سال - توانایی خواندن و درک فارسی - تشخیص کم کاری تیروئید آشکار حداقل 6 ماه قبل از ورود - مونوتراپی ثابت و منظم LT4 حداقل 3 ماه قبل از ورود -علائم و نشانه های کم کاری تیروئید گزارش شده توسط بیمار از جمله خستگی، تغییر خلق و خو، افزایش وزن، بی حالی، کاهش عملکرد روانی حرکتی، افسردگی، و اختلالات علیرغم سطح طبیعی هورمون تیروئید معیارهای خروج: - بارداری یا بارداری برنامه ریزی شده در 6 ماه آینده - بیماران مبتلا به اعتیاد به مواد مخدر یا الکل - بیماران مبتلا به بدخیمی ، بیماری های قلبی عروقی ، بیماری کلیوی یا کبدی ، بیماری مزمن کبدی ، افسردگی، اضطراب - بیماران مبتلا به بیماری روانی که قبل از ورود به مطالعه به مدت 6 ماه تحت درمان روانپزشکی بوده اند
    Group A levothyroxine with placebo and group B levothyroxine and liothyronine 12.5 mcg twice daily
    Patients will be randomized to continue receiving their usual dose of LT4 (100 µg/day) in the combination of placebo for 6 months (Group 1), or change their usual treatment to the combination therapy of LT4 50 µg and LT3 6.25 µg twice a day (Group 2) The placebo will be “liothyronine” and labeled “approved for research purposes only”.
    گروه A لووتیروکسین به همراه پلاسبو وگروه B لووتیروکسین و لیوتیرونین با دوز 12.5 میکروگرم دو بار در روز
    بیماران به طور تصادفی برای ادامه دریافت دوز معمول LT4 (دوز شروع به طور متوسط ​​100 میکروگرم در روز) در ترکیب دارونما (برای اطمینان از کور شدن) به مدت 6 ماه قرار خواهند گرفت، (گروه 1) یا درمان معمول خود را به ترکیب LT4 50 میکروگرم و LT3 با 6.25میکروگرم دو بار در روز) تغییر دهند. (گروه 2). دارونما "لیوتیرونین" و برچسب "فقط برای اهداف تحقیقاتی تایید شده" خواهد بود.
    weight / lipid profile / quality of life
    changes in quality of life between baseline and follow-up visits of the
    تغییر وزن ،پروفایل چربی،کیفیت زندگی
    - تغییرات کیفیت زندگی بین ویزیت پایه وپیگیری
  • General information

    Not used
    Used
    126
    151
    At least 6 months have passed since their hypothyroid diagnosis
    Levothyroxine is taken regularly
    Their dose of levothyroxine has been stable for the past 3 months
    .Although their thyroid tests (TSH-T4) are in the normal range, they have symptoms such as fatigue, weight loss, lethargy, decreased psychomotor activity, and depression
    Get a score above 100 based on the General Health Standard Questionnaire SF36
    Age over 16 years
    Being able to read and understand Persian
    Diagnosis of overt hypothyroidism at least 6 months before inclusion
    Stable and regular LT4 monotherapy for at least 3 months before
    Patient-reported signs and symptoms of hypothyroidism including fatigue, mood change, weight gain, lethargy, decreased psychomotor performance conative, depression, and disturbances despite normal thyroid hormone levels
    حداقل 6 ماه از تشخیص هیپوتیروئیدی آنها گذشته است.
    داروی لووتیروکسین را به طور منظم مصرف می کنند.
    دوز لووتیروکسین آنها در 3 ماه اخیر ثابت بوده است.
    با وجود اینکه آزمایشات تیروئیدی آنها (TSH –T4 )در محدوده ی طبیعی قرار دارد ولی دارای علایمی مانند خستگی، کاهش وزن، لتارژی، کاهش فعالیت سایکوموتور و افسردگی هستند .
    گرفتن نمره بالای 100 بر اساس پرسشنامه استاندارد سلامت عمومی SF36
    سن بالای 16 سال
    قابلیت داشتن در خواندن وفهمیدن فارسی
    تشخیص هیپوتیروئیدی آشکار حداقل از 6 ماه قبل
    مونوتراپی ثابت و منظم LT4 حداقل 3 ماه قبل
    علائم و نشانه های کم کاری تیروئید گزارش شده توسط بیمار از جمله خستگی، تغییر خلق و خو، افزایش وزن، بی حالی، کاهش عملکرد روانی حرکتی، افسردگی، و اختلالات علیرغم سطح طبیعی هورمون تیروئید
    Malignancy
    Pregnancy
    Drug or alcohol addiction
    Cardiovascular patients / Kidney failure / Liver failure / Patients with a history of heart disease/
    Nervous disease or people who have been using psychiatric medication for the past 6 months
    Pregnancy or planned pregnancy within the next 6 months
    Patients with drug or alcohol addiction
    Patients with Malignancy
    Patients with cardiovascular disease
    Patients with renal, or hepatic disease
    Patients with chronic liver disease
    Patients with depression, anxiety
    Patients with mental illness and had been on psychiatric medicine for 6 months before inclusion
    بدخیمی
    بارداری
    اعتیاد به مواد مخدر و الکل
    بیماری قلبی عروقی/ بیماری کبدی و کلیوی / بیماران با سابقه بیماری قلبی
    اختلالات عصبی و سابقه مصرف داروهای اعصاب و روان طی 6 ماه اخیر
    بارداری یا بارداری برنامه ریزی شده در 6 ماه آینده
    بیماران مبتلا به اعتیاد به مواد مخدر یا الکل
    بیماران مبتلا به بدخیمی
    بیماران مبتلا به بیماری های قلبی عروقی
    بیماران مبتلا به بیماری کلیوی یا کبدی
    بیماران مبتلا به بیماری مزمن کبدی
    بیماران مبتلا به افسردگی، اضطراب
    بیماران مبتلا به بیماری روانی و قبل از ورود به مطالعه به مدت 6 ماه تحت درمان روانپزشکی بوده اند
    Group A (levothyroxine and levothyronine recipients) and B (levothyroxine recipients alone) were divided. In this way, all possible four blocks (158 blocks), which include two groups, are written, and each number is assigned to one of the blocks in the table, which shows its own state. Randomly, based on the table of random numbers obtained by the computer program, a block is selected and based on that, the samples entered into the study will enter different groups. This work will continue to reach a sufficient number of samples in each group. For example, if block 1 is selected in the first selection, ie the first two samples enter group (A), the third and fourth samples enter group (B). And for the next 4 samples, the block will be selected again.
    We will design a randomized, double-blind (both patients and physicians), parallel-group comparison trial in a 1:1 ratio, and patients are randomly assign following procedures to LT4+placebo or LT4+LT3 treatment groups. The list of random allocation cards will be generated by an independent trained researcher using computer-generated random numbers. To avoid the confusion of coding A or B, the researcher will keeps the original random allocation sequences in an inaccessible third place and works with a copy.
    گروه A (دریافت کنندگان لووتیروکسین و لیوتیرونین ) و B ( دریافت کنندگان لووتیروکسین به تنهایی) تقسیم شدند. به این صورت که تمامی بلوک های چهار تایی ممکن (158بلوک)که شامل دو گروه می شود نوشته شده و هر شماره ای به یکی از بلوک های جدول اختصاص دارد که حالت خاص خود را نشان می دهد. به طور تصادفي و براساس جدول اعداد تصادفي كه توسط برنامه كامپيوتري به دست آمده یک بلوک انتخاب شده و براساس ان نمونه های وارد شده به مطالعه وارد گروه های مختلف خواهند شد.این کار ادامه خواهد داشت تا به تعداد نمونه کافی در هر گروه برسیم. برای مثال اگر در انتخاب اول بلوک شماره 1 انتخاب شد یعنی دو نمونه اول وارد گروه (A) ، نمونه سوم و چهارم وارد گروه (B) می شود. و برای 4 نمونه بعد دوباره بلوک انتخاب خواهد شد.
    ما یک کارآزمایی مقایسه ای تصادفی، دوسوکور (هم بیماران و هم پزشکان)، گروه موازی را در نسبت 1:1 طراحی خواهیم کرد.و بیماران به طور تصادفی به گروه های درمانی LT4+دارونما یا LT4+LT3 اختصاص می دهند. لیست کارت های تخصیص تصادفی توسط یک محقق آموزش دیده مستقل و با استفاده از اعداد تصادفی تولید شده توسط کامپیوتر ایجاد می شود.برای جلوگیری از سردرگمی محقق توالی های تخصیص تصادفی اصلی را در مکان سوم غیرقابل دسترس با کدگذاری A یا B،نگه می دارد.و با یک کپی کار می کند.
    In this study, the drugs received in the two groups of patients are exactly the same shape and size and are given to them by clinical caregivers and patients are not aware of the type of drug combination. On the other hand, the researcher only examines and records the variables in the patients without knowing the type of medicine received.
    The placebo will be placed into envelopes according to the allocation orders by another independent nurse who was not aware of the study. The patient's ID, visit date, and other information will be recorded on each envelope. Neither the patients nor the physicians who will assess the patients are aware of the treatment. After 6 months, another independent researcher who is not aware of the treatment will assess the patient's health-related quality of life scores.
    در این مطالعه داروهای دریافتی در دو گروه بیمار کاملا به یک شکل و اندازه بوده و توسط مراقبین بالینی به ان ها داده می شود و بیماران از نوع ترکیب دارو اطلاعی ندارند. از سوی دیگر محقق نیز بدون اطلاع از نوع داروی دریافتی تنها به بررسی و ثبت متغیرها در بیماران می پردازد.
    دارونما طبق دستورات تخصیص یافته توسط پرستار مستقل دیگری که از مطالعه آگاه نبود در پاکت ها قرار می گیرد. شناسه بیمار، تاریخ ویزیت و سایر اطلاعات روی هر پاکت ثبت می شود.نه بیماران و نه پزشکانی که بیماران را ارزیابی خواهند کرد از درمان آگاه نیستند. پس از 6 ماه، محقق مستقل دیگری که از درمان آگاه نیست، نمرات کیفیت زندگی بیمار را در ارتباط با سلامت ارزیابی خواهد کرد.
  • Primary outcomes

    #1
    Quality of life score and cognitive function in the SF36 General Health Standard Questionnaire
    The quality of life changes between baseline and follow-up visits of the Physical component summary in SF-36V1
    نمره کیفیت زندگی و عملکرد شناختی در پرسشنامه استاندار سلامت عمومی SF36
    تغییرات کیفیت زندگی بین بازدیدهای پایه و پیگیری از خلاصه اجزای فیزیکی در SF-36V1
    SF36 standard health standard questionnaire score and IPAQ physical activity before intervention and 6 months after drug administration
    Before study (baseline) , follow-up visit (6 months later)
    نمره پرسشنامه استاندار سلامت عمومی SF36 و فعالیت بدنی قبل از شروع مداخله و 6 ماه بعد از شروع مصرف دارو
    قبل از مطالعه (پایه)، ویزیت پیگیری (6 ماه بعد)
    IPAQQ Physical Activity Questionnaire and SF36 General Health
    The 36-item Short-Form Health Survey version 1 (SF-36V1) questionnaire
    پرسشنامه فعالیت بدنی IPAQQ و سلامت عمومی SF36
    پرسشنامه 36 سوالی فرم کوتاه بررسی سلامت نسخه 1 (SF-36V1)
    #2
    empty
    The quality of life changes between baseline and follow-up visits of the Mental component summary in SF-36V1
    empty
    تغییرات کیفیت زندگی بین بازدیدهای اولیه و پیگیری از خلاصه مؤلفه ذهنی در SF-36V1
    empty
    Before study (baseline) , follow-up visit (6 months later)
    empty
    قبل از مطالعه (پایه)، ویزیت پیگیری (6 ماه بعد)
    empty
    The 36-item Short-Form Health Survey version 1 (SF-36V1) questionnaire
    empty
    پرسشنامه 36 سوالی فرم کوتاه بررسی سلامت نسخه 1 (SF-36V1)
    #3
    empty
    The quality of life changes between baseline and follow-up visits of the Physical functioning domain in SF-36V1
    empty
    تغییرات کیفیت زندگی بین بازدیدهای اولیه و پیگیری از حوزه عملکرد فیزیکی در SF-36V1
    empty
    Before study (baseline) , follow-up visit (6 months later)
    empty
    قبل از مطالعه (پایه)، ویزیت پیگیری (6 ماه بعد)
    empty
    The 36-item Short-Form Health Survey version 1 (SF-36V1) questionnaire
    empty
    پرسشنامه 36 سوالی فرم کوتاه بررسی سلامت نسخه 1 (SF-36V1)
    #4
    empty
    The quality of life changes between baseline and follow-up visits of the Social functioning domain in SF-36V1
    empty
    تغییرات کیفیت زندگی بین بازدیدهای اولیه و پیگیری از حوزه عملکرد فیزیکی در SF-36V1
    empty
    Before study (baseline) , follow-up visit (6 months later)
    empty
    قبل از مطالعه (پایه)، ویزیت پیگیری (6 ماه بعد)
    empty
    The 36-item Short-Form Health Survey version 1 (SF-36V1) questionnaire
    empty
    پرسشنامه 36 سوالی فرم کوتاه بررسی سلامت نسخه 1 (SF-36V1)
    #5
    empty
    The quality of life changes between baseline and follow-up visits of the Vitality domain in SF-36V1
    empty
    تغییرات کیفیت زندگی بین بازدیدهای اولیه و پیگیری از حوزه حیات در SF-36V1
    empty
    Before study (baseline) , follow-up visit (6 months later)
    empty
    قبل از مطالعه (پایه)، ویزیت پیگیری (6 ماه بعد)
    empty
    The 36-item Short-Form Health Survey version 1 (SF-36V1) questionnaire
    empty
    پرسشنامه 36 سوالی فرم کوتاه بررسی سلامت نسخه 1 (SF-36V1)
    #6
    empty
    The quality of life changes between baseline and follow-up visits of the General mental health domain in SF-36V1
    empty
    تغییرات کیفیت زندگی بین بازدیدهای اولیه و پیگیری از حوزه سلامت روان عمومی در SF-36V1
    empty
    Before study (baseline) , follow-up visit (6 months later)
    empty
    قبل از مطالعه (پایه)، ویزیت پیگیری (6 ماه بعد)
    empty
    The 36-item Short-Form Health Survey version 1 (SF-36V1) questionnaire
    empty
    پرسشنامه 36 سوالی فرم کوتاه بررسی سلامت نسخه 1 (SF-36V1)
    #7
    empty
    The quality of life changes between baseline and follow-up visits of the Bodily pain domain in SF-36V1
    empty
    تغییرات کیفیت زندگی بین بازدیدهای اولیه و پیگیری از دامنه درد بدن در SF-36V1
    empty
    Before study (baseline) , follow-up visit (6 months later)
    empty
    قبل از مطالعه (پایه)، ویزیت پیگیری (6 ماه بعد)
    empty
    The 36-item Short-Form Health Survey version 1 (SF-36V1) questionnaire
    empty
    پرسشنامه 36 سوالی فرم کوتاه بررسی سلامت نسخه 1 (SF-36V1)
    #8
    empty
    The quality of life changes between baseline and follow-up visits of the Limitations in physical activities domain in SF-36V1
    empty
    تغییرات کیفیت زندگی بین بازدیدهای اولیه و پیگیری از حوزه محدودیت در فعالیت های بدنی در SF-36V1
    empty
    Before study (baseline) , follow-up visit (6 months later)
    empty
    قبل از مطالعه (پایه)، ویزیت پیگیری (6 ماه بعد)
    empty
    The 36-item Short-Form Health Survey version 1 (SF-36V1) questionnaire
    empty
    پرسشنامه 36 سوالی فرم کوتاه بررسی سلامت نسخه 1 (SF-36V1)
    #9
    empty
    The quality of life changes between baseline and follow-up visits of the General health perceptions domain in SF-36V1
    empty
    تغییرات کیفیت زندگی بین بازدیدهای اولیه و پیگیری از حوزه ادراکات سلامت عمومی در SF-36V1
    empty
    Before study (baseline) , follow-up visit (6 months later)
    empty
    قبل از مطالعه (پایه)، ویزیت پیگیری (6 ماه بعد)
    empty
    The 36-item Short-Form Health Survey version 1 (SF-36V1) questionnaire
    empty
    پرسشنامه 36 سوالی فرم کوتاه بررسی سلامت نسخه 1 (SF-36V1)
    #10
    empty
    The quality of life changes between baseline and follow-up visits of the Limitations due to emotional problems domain in SF-36V1
    empty
    تغییرات کیفیت زندگی بین بازدیدهای اولیه و پیگیری از حوزه محدودیت ها به دلیل مشکلات عاطفی در SF-36V1
    empty
    Before study (baseline) , follow-up visit (6 months later)
    empty
    قبل از مطالعه (پایه)، ویزیت پیگیری (6 ماه بعد)
    empty
    The 36-item Short-Form Health Survey version 1 (SF-36V1) questionnaire
    empty
    پرسشنامه 36 سوالی فرم کوتاه بررسی سلامت نسخه 1 (SF-36V1)
  • Secondary outcomes

    #1
    change of weight from the baseline visit
    changes between baseline and follow-up visits of the weight
    #2
    change of Blood pressure from the baseline visit
    changes between baseline and follow-up visits of the Blood pressure
    #3
    change of Serum TSH
    changes between baseline and follow-up visits of the Serum TSH
    #4
    change of Serum total cholesterol
    changes between baseline and follow-up visits of the Serum total cholesterol
    #5
    change of Serum triglyceride
    changes between baseline and follow-up visits of the Serum triglyceride
    #6
    change of Serum LDL cholesterol
    changes between baseline and follow-up visits of the Serum LDL cholesterol
    #7
    change of Serum HDL cholesterol
    changes between baseline and follow-up visits of the Serum HDL cholesterol
    #8
    change Change in physical activity
    changes between baseline and follow-up visits of the in physical activity
  • Intervention groups

    #1
    Intervention group: Patients receiving levothyroxine and leiothyronine combination drugs/One group of levothyroxine with placebo and the other group of levothyroxine and leiothyronine in two doses of 6.25 per day
    Patients are randomized to continue receiving their usual dose of LT4 (starting dose of an average of 100 µg/day) in the combination of placebo (liothyronine: to ensure blinding) for 6 months (Group 1)
    گروه مداخله: بیماران دریافت کنندگان درمات ترکیبی لووتیروکسین و لیوتیرونین /یک گروه لووتیروکسین به همراه پلاسبو و به گروه دیگر لووتیروکسین و لییوتیرونین در دو دوز 6.25 در روز
    بیماران به طور تصادفی برای ادامه دریافت دوز معمول LT4 (دوز شروع به طور متوسط ​​100 میکروگرم در روز) در ترکیب دارونما (لیوتیرونین: برای اطمینان از کور شدن) به مدت 6 ماه (گروه 1) قرار می گیرند.
    #2
    Control group: Levothyroxine recipients alone
    the combination therapy of LT4 (LT4 dose at the time of inclusion-50 µg) and LT3 (6.25 µg twice a day) (Group 2).
    گروه کنترل: دریافت کنندگان لووتیروکسین به تنهایی
    درمان ترکیبی LT4 (دوز LT4 در زمان ورود - 50 میکروگرم) و LT3 (6.25 میکروگرم دو بار در روز) (گروه 2).

Protocol summary

Study aim
the present RCT will be conducted to evaluate the effect of combined LT4+LT3 therapy vs LT4 alone on the quality of life.
Design
A randomized, double-blind, parallel-group comparison trial in a 1:1 ratio including the baseline (April- Oct 2020 ) and the 6-months follow-up
Settings and conduct
Hypothyroid patients with levothyroxine monotherapy and normal TSH In this double blind study, patients divided in two groups Place of study: Sayad Shirazi Hospital Endocrinology Clinic, Gorgan
Participants/Inclusion and exclusion criteria
Inclusion Criteria Age over 16 years Being able to read and understand Persian Diagnosis of overt hypothyroidism at least 6 months before inclusion Stable and regular LT4 monotherapy for at least 3 months before inclusion Patient-reported signs and symptoms of hypothyroidism including fatigue, mood change, weight gain, lethargy, decreased psychomotor performance conative, depression, and disturbances despite normal thyroid hormone levels Exclusion criteria Pregnancy or planned pregnancy within the next 6 months Patients with drug or alcohol addiction Patients with Malignancy, cardiovascular disease ,renal, or hepatic disease, chronic liver disease ,depression, anxiety Patients with mental illness and had been on psychiatric medicine for 6 months before inclusion
Intervention groups
Patients will be randomized to continue receiving their usual dose of LT4 (100 µg/day) in the combination of placebo for 6 months (Group 1), or change their usual treatment to the combination therapy of LT4 50 µg and LT3 6.25 µg twice a day (Group 2) The placebo will be “liothyronine” and labeled “approved for research purposes only”.
Main outcome variables
changes in quality of life between baseline and follow-up visits of the

General information

Reason for update
Change questionnaire
Acronym
IRCT registration information
IRCT registration number: IRCT20200410047012N1
Registration date: 2020-06-12, 1399/03/23
Registration timing: registered_while_recruiting

Last update: 2022-07-13, 1401/04/22
Update count: 4
Registration date
2020-06-12, 1399/03/23
Registrant information
Name
Fatemeh Hajtalebi
Name of organization / entity
Country
Iran (Islamic Republic of)
Phone
+98 17 3235 4068
Email address
fahajtalebi@yahoo.com
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2020-03-19, 1398/12/29
Expected recruitment end date
2020-09-20, 1399/06/30
Actual recruitment start date
2020-03-19, 1398/12/29
Actual recruitment end date
2020-09-20, 1399/06/30
Trial completion date
2021-03-18, 1399/12/28
Scientific title
Study the effect of combination therapy with levothyroxine and leiothyronine in comparison with levothyroxine on Well-Being, Quality of Life, or Cognitive Function in Patients with Primary Hypothyroidism
Public title
effect of combination therapy of levothyroxine and levothyronine in comparison with levothyroxine in quality of life and cognitive function of patients with primary hypothyroidism
Purpose
Supportive
Inclusion/Exclusion criteria
Inclusion criteria:
Age over 16 years Being able to read and understand Persian Diagnosis of overt hypothyroidism at least 6 months before inclusion Stable and regular LT4 monotherapy for at least 3 months before Patient-reported signs and symptoms of hypothyroidism including fatigue, mood change, weight gain, lethargy, decreased psychomotor performance conative, depression, and disturbances despite normal thyroid hormone levels
Exclusion criteria:
Pregnancy or planned pregnancy within the next 6 months Patients with drug or alcohol addiction Patients with Malignancy Patients with cardiovascular disease Patients with renal, or hepatic disease Patients with chronic liver disease Patients with depression, anxiety Patients with mental illness and had been on psychiatric medicine for 6 months before inclusion
Age
From 16 years old
Gender
Both
Phase
3
Groups that have been masked
  • Participant
  • Investigator
Sample size
Target sample size: 158
Actual sample size reached: 151
Randomization (investigator's opinion)
Randomized
Randomization description
We will design a randomized, double-blind (both patients and physicians), parallel-group comparison trial in a 1:1 ratio, and patients are randomly assign following procedures to LT4+placebo or LT4+LT3 treatment groups. The list of random allocation cards will be generated by an independent trained researcher using computer-generated random numbers. To avoid the confusion of coding A or B, the researcher will keeps the original random allocation sequences in an inaccessible third place and works with a copy.
Blinding (investigator's opinion)
Double blinded
Blinding description
The placebo will be placed into envelopes according to the allocation orders by another independent nurse who was not aware of the study. The patient's ID, visit date, and other information will be recorded on each envelope. Neither the patients nor the physicians who will assess the patients are aware of the treatment. After 6 months, another independent researcher who is not aware of the treatment will assess the patient's health-related quality of life scores.
Placebo
Used
Assignment
Parallel
Other design features

Secondary Ids

empty

Ethics committees

1

Ethics committee
Name of ethics committee
Ethics committee of Gorgan University of Medical Sciences
Street address
Ethics Committee of the Vice Chancellor for Research and Technology, 3rd Floor, School of Dentistry, Golestan University of Medical Sciences, Shast Kola Road, Gorgan, Iran
City
Gorgan
Province
Golestan
Postal code
4915663158
Approval date
2020-04-12, 1399/01/24
Ethics committee reference number
IR.Goums.Rec.1399.016

Health conditions studied

1

Description of health condition studied
Hypothyroidism
ICD-10 code
E03
ICD-10 code description
Other hypothyroidism

Primary outcomes

1

Description
The quality of life changes between baseline and follow-up visits of the Physical component summary in SF-36V1
Timepoint
Before study (baseline) , follow-up visit (6 months later)
Method of measurement
The 36-item Short-Form Health Survey version 1 (SF-36V1) questionnaire

2

Description
The quality of life changes between baseline and follow-up visits of the Mental component summary in SF-36V1
Timepoint
Before study (baseline) , follow-up visit (6 months later)
Method of measurement
The 36-item Short-Form Health Survey version 1 (SF-36V1) questionnaire

3

Description
The quality of life changes between baseline and follow-up visits of the Physical functioning domain in SF-36V1
Timepoint
Before study (baseline) , follow-up visit (6 months later)
Method of measurement
The 36-item Short-Form Health Survey version 1 (SF-36V1) questionnaire

4

Description
The quality of life changes between baseline and follow-up visits of the Social functioning domain in SF-36V1
Timepoint
Before study (baseline) , follow-up visit (6 months later)
Method of measurement
The 36-item Short-Form Health Survey version 1 (SF-36V1) questionnaire

5

Description
The quality of life changes between baseline and follow-up visits of the Vitality domain in SF-36V1
Timepoint
Before study (baseline) , follow-up visit (6 months later)
Method of measurement
The 36-item Short-Form Health Survey version 1 (SF-36V1) questionnaire

6

Description
The quality of life changes between baseline and follow-up visits of the General mental health domain in SF-36V1
Timepoint
Before study (baseline) , follow-up visit (6 months later)
Method of measurement
The 36-item Short-Form Health Survey version 1 (SF-36V1) questionnaire

7

Description
The quality of life changes between baseline and follow-up visits of the Bodily pain domain in SF-36V1
Timepoint
Before study (baseline) , follow-up visit (6 months later)
Method of measurement
The 36-item Short-Form Health Survey version 1 (SF-36V1) questionnaire

8

Description
The quality of life changes between baseline and follow-up visits of the Limitations in physical activities domain in SF-36V1
Timepoint
Before study (baseline) , follow-up visit (6 months later)
Method of measurement
The 36-item Short-Form Health Survey version 1 (SF-36V1) questionnaire

9

Description
The quality of life changes between baseline and follow-up visits of the General health perceptions domain in SF-36V1
Timepoint
Before study (baseline) , follow-up visit (6 months later)
Method of measurement
The 36-item Short-Form Health Survey version 1 (SF-36V1) questionnaire

10

Description
The quality of life changes between baseline and follow-up visits of the Limitations due to emotional problems domain in SF-36V1
Timepoint
Before study (baseline) , follow-up visit (6 months later)
Method of measurement
The 36-item Short-Form Health Survey version 1 (SF-36V1) questionnaire

Secondary outcomes

1

Description
changes between baseline and follow-up visits of the weight
Timepoint
Before the intervention and 6 months after taking the drug
Method of measurement
digital scale

2

Description
changes between baseline and follow-up visits of the Blood pressure
Timepoint
Before the intervention and 6 months after taking the drug
Method of measurement
manual auscultatory device

3

Description
changes between baseline and follow-up visits of the Serum TSH
Timepoint
Before the intervention and 6 months after taking the drug
Method of measurement
immunochemiluminometric assay

4

Description
changes between baseline and follow-up visits of the Serum total cholesterol
Timepoint
Before the intervention and 6 months after taking the drug
Method of measurement
enzymatic colorimetric methods

5

Description
changes between baseline and follow-up visits of the Serum triglyceride
Timepoint
Before the intervention and 6 months after taking the drug
Method of measurement
enzymatic colorimetric methods

6

Description
changes between baseline and follow-up visits of the Serum LDL cholesterol
Timepoint
Before the intervention and 6 months after taking the drug
Method of measurement
enzymatic colorimetric methods

7

Description
changes between baseline and follow-up visits of the Serum HDL cholesterol
Timepoint
Before the intervention and 6 months after taking the drug
Method of measurement
precipitation method

8

Description
changes between baseline and follow-up visits of the in physical activity
Timepoint
Before the intervention and 6 months after taking the drug
Method of measurement
International Physical Activity Questionnaire short form (IPAQ20)

Intervention groups

1

Description
Patients are randomized to continue receiving their usual dose of LT4 (starting dose of an average of 100 µg/day) in the combination of placebo (liothyronine: to ensure blinding) for 6 months (Group 1)
Category
Treatment - Drugs

2

Description
the combination therapy of LT4 (LT4 dose at the time of inclusion-50 µg) and LT3 (6.25 µg twice a day) (Group 2).
Category
Treatment - Drugs

Recruitment centers

1

Recruitment center
Name of recruitment center
Shahid Sayad Shirazi Hospital in Gorgan
Full name of responsible person
Fateme Hajtalebi
Street address
Endocrinology and Metabolism Clinic, Ground Floor, Shahid Sayad Shirazi Hospital, Sayad Shirazi Blvd., Bahonar Square, Gorgan, Iran
City
Gorgan
Province
Golestan
Postal code
4915663158
Phone
+98 17 3226 1150
Email
fahajtalebi@yahoo.com

Sponsors / Funding sources

1

Sponsor
Name of organization / entity
Gorgan University of Medical Sciences
Full name of responsible person
Dr.Mahammad Reza Honarvar
Street address
Ethics Committee of the Vice Chancellor for Research and Technology, 3rd Floor, School of Dentistry, Golestan University of Medical Sciences, Shast Kola Road, Gorgan, Iran
City
Gorgan
Province
Golestan
Postal code
4915663158
Phone
+98 17 3245 1660
Email
fahajtalebi@yahoo.com
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Gorgan University of Medical Sciences
Proportion provided by this source
100
Public or private sector
Public
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Academic

Person responsible for general inquiries

Contact
Name of organization / entity
Gorgan University of Medical Sciences
Full name of responsible person
Dr Hamide Akbari
Position
Assistant Professor
Latest degree
Subspecialist
Other areas of specialty/work
Internal Medicine
Street address
Endocrinology and Metabolism Clinic, Ground Floor, Shahid Sayad Shirazi Hospital, Sayad Shirazi Blvd., Bahonar Square, Gorgan, Iran
City
Gorgan
Province
Golestan
Postal code
4915663158
Phone
+98 17 3220 3564
Email
fahajtalebi@yahoo.com

Person responsible for scientific inquiries

Contact
Name of organization / entity
Gorgan University of Medical Sciences
Full name of responsible person
Fatemeh Hajtalebi
Position
Resident
Latest degree
Medical doctor
Other areas of specialty/work
Internal Medicine
Street address
Alley of Martyr Shibak_Janbazan Boulevard
City
Gorgan
Province
Golestan
Postal code
4915663158
Phone
+98 17 3235 4068
Fax
Email
fahajtalebi@yahoo.com

Person responsible for updating data

Contact
Name of organization / entity
Gorgan University of Medical Sciences
Full name of responsible person
Fatemeh Hajtalebi
Position
Resident
Latest degree
Medical doctor
Other areas of specialty/work
Internal Medicine
Street address
Alley of Martyr Shibak_Janbazan Boulevard
City
Gorgan
Province
Golestan
Postal code
4915663158
Phone
+98 17 3235 4068
Fax
Email
fahajtalebi@yahoo.com

Sharing plan

Deidentified Individual Participant Data Set (IPD)
Yes - There is a plan to make this available
Study Protocol
No - There is not a plan to make this available
Statistical Analysis Plan
No - There is not a plan to make this available
Informed Consent Form
Yes - There is a plan to make this available
Clinical Study Report
No - There is not a plan to make this available
Analytic Code
No - There is not a plan to make this available
Data Dictionary
No - There is not a plan to make this available
Title and more details about the data/document
All data in this study can be shared without identifying individuals.
When the data will become available and for how long
Start access 3 months after printing the results
To whom data/document is available
Data from this study will only be available to researchers working at academic and research institutes and specialist physicians
Under which criteria data/document could be used
There are no restrictions on data analysis
From where data/document is obtainable
Dr. Fatemeh Talebi / Email: Fahajtalebi@yahoo.com/ Phone Number: 09151042897
What processes are involved for a request to access data/document
The applicant will be able to access the document after submitting documents regarding the reason for requesting the data file and determining the identity of the person (specialist or researcher).
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