High-dose levothyroxine (L-T4) therapy safely raises thyroid hormone levels in adult RTHα patients without adverse clinical effects over three years.
Patients report improved quality of life despite biochemical profiles showing supraphysiological free thyroxine (FT4), free triiodothyronine (FT3), and reverse T3 (rT3) levels with suppressed TSH.
Metabolomic analyses reveal significant reductions in multiple lipid classes, with no changes in bone mineral density (BMD), indicating nuanced metabolic consequences of therapy.
Introduction of liothyronine (L-T3) replacement raises concerns due to cardiac arrhythmia in one patient, emphasizing cautious titration and monitoring.
