Daily Versus Alternate Day Thyroxine Therapy to Maintain Euthyroidism in Children With Congenital Hypothyroidism

BACKGROUND Daily administration of thyroxine has proven efficacy in treatment of children with hypothyroidism. However, the possibility of treatment with longer dosing intervals that offers flexibility and choice in maintaining euthyroid state has not been tested in children. OBJECTIVES To study the efficacy of an alternate day regimen to maintain euthyroidism in children with congenital hypothyroidism. PATIENTS AND METHODS Forty patients given alternate day therapy, while 30 children continued on their daily regimen were followed up at monthly intervals for 3 months. Clinical and laboratory assessments were performed at each follow up visit. RESULTS The clinical and anthropometric parameters remained similar in both groups of patients during the study indicating a maintained euthyroid state clinically. The thyroid profiles also remained within normal limits suggesting biochemical euthyroidism status with alternate day therapy. However the baseline serum aminotransferase levels showed mild elevation in patients on alternate day regimen and the difference persisted during the follow up visits. Higher HDL and lower TC and LDL levels suggested some beneficial effect of alternate day schedule on lipid profiles. CONCLUSIONS In short-term, alternate day schedule can be effectively used to maintain clinical and biochemical euthyroid state in children with congenital hypothyroidism beyond 4 years of age.