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CompletedNCT03095963Updated Mar 30, 2017

Interaction Between Levothyroxine and Probiotics in Hypothyroid Patients

An interventional study of a mixture of highly charged Lactobacilli and Bifidobacteria (VSL#3®) and levothyroxin in Hypothyroidism, sponsored by Azienda USL Modena. Completed. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2017-03-30.

Sponsored by Azienda USL Modena · Not applicable, Interventional, and Other

Phase
Not applicable
Study type
Interventional
Enrollment
80
Allocation
Randomized
Ages
18 Years to 65 Years
Sex
All
01

Study summary

A prospective, randomized, single-blind, controlled, investigator-started clinical trial was carried out. Patients with primary hypothyroidism were randomly assigned to the study (VSL#3®+ LT4) and the control group (LT4). A two months treatment phase was followed by two months of follow-up. Clinical examination, blood tests for thyroid function and for peripheral tissue markers of thyroid hormones effect were performed monthly for 4 months. LT4 dose adjustments were performed during the study when necessary.

Read the detailed description

Consecutive patients on LT4 replacement therapy attending the Endocrinology Unit of Modena (Italy) were screened. According to inclusion and exclusion criteria, eighty participants were enrolled and randomized in study or control group. The random allocation sequence was generated using 'Statistical Package for the Social Sciences' software for Macintosh (SPSS) considering a 1:1 ratio by the statistician of the Unit. Clinicians evaluating and enrolling patients were blinded to the randomization list. The study design provided a monthly visit for a 4 months overall time-frame. Patients assigned to the study group took the probiotic supplement VSL#3® for two months, followed by a two months period of follow-up. Study group patients were taught to assume the probiotic supplement at least two hours after LT4 administration, to dissolve it in a cold beverage and to store it in a refrigerator (2°-8°C) in order to preserve bacteria load. The study design was single-blind since only the clinician was aware of the allocation. The VSL#3® administration was provided by nurses. Participants were invited to return all used and unused sachets to count the number of opened sachets per the number of treatment days.

All patients underwent five visits (baseline, visit 1, 2, 3 and 4) in which anthropometrical evaluation (weight and height) and hormonal function assessment were performed. A blood sample was taken in the morning at each visit, on empty stomach and before LT4 ingestion. In occurrence of hormonal alteration, LT4 daily dose was adjusted according to clinical guidelines. At baseline, visit 2 and visit 4, patients underwent clinical examination with heart rate and blood pressure evaluation. During each visit, the following data were collected: probiotic assumption, sex, age, hypothyroidism aetiology, LT4 formulation dose and brand, body mass index (BMI), body surface area (BSA), systolic blood pressure, diastolic blood pressure, heart rate, TSH, fT4, fT3 and any possible LT4 posology adjustment. All the clinical data have been further databased.

02

Conditions studied

  • Hypothyroidism

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03

In context

Hypothyroidism

217 studies on the registry are indexed under Hypothyroidism; 50 are open to participants now.

This study's enrollment of 80 is above the median of 70 across 109 interventional studies indexed under Hypothyroidism.

Browse Hypothyroidism studies →

Lead sponsor

Azienda USL Modena is the lead sponsor of 11 studies on the registry; 1 is open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • primary hypothyroidism on LT4 replacement therapy
  • TSH, fT3 and fT4 in the normal range
  • stable LT4 dosage during the previous six months before enrolment
  • Caucasian ethnicity

Exclusion criteria

Exclusion Criteria:

  • total thyroidectomy for thyroid carcinoma
  • high fiber diet
  • intestinal malabsorption (e.g. bariatric surgery, inflammatory bowel diseases, coeliac disease)
  • ongoing therapies interfering with LT4 absorption and/or metabolism (i.e. aluminium-containing antacids, sucralfate, proton pump inhibitors, calcium carbonate, raloxifene, bile acids sequestrants and ferrous sulfate)
  • antibiotics treatment in the previous six months before enrolment
05

Study design

Phase
Not applicable
Primary purpose
Other
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Investigator)
Enrollment
80 participants (actual)

Study arms

  • Active comparator
    Probiotics

    The study group took a mixture of highly charged Lactobacilli and Bifidobacteria (VSL#3®) in addition to levothyroxine

    Other: a mixture of highly charged Lactobacilli and Bifidobacteria (VSL#3®) · Drug: levothyroxin

  • Active comparator
    Levothyroxine

    The control group took levothyroxine only

    Drug: levothyroxin

Interventions

  • Othera mixture of highly charged Lactobacilli and Bifidobacteria (VSL#3®)

    Patients assigned to the study group took the probiotic supplement VSL#3® for two months, in addition to levothyroxine

  • replacement therapy for hypothyroidism

06

What researchers measure

Primary outcomes

  1. differences in thyroid-stimulating hormone (TSH) serum levels comparing study group and controls

    measurement of serum levels of thyroid-stimulating hormone (TSH) - unit of measure: microIU/mL, normal range: 0.35-4.94

    Time frame: Through study completion, an average of 4 months

Secondary outcomes

  1. differences in peripheral tissue markers of thyroid hormones by biochemical assays comparing study group and controls

    measurement of serum levels of total cholesterol (CH) - unit of measure: mg/dL, normal range: \<200

    Time frame: Through study completion, an average of 4 months

  2. differences in peripheral tissue markers of thyroid hormones by biochemical assays comparing study group and controls

    measurement of serum levels of sex hormone-binding globulin (SHBG) - unit of measure: nmol/L, normal range: males 13.5-71.4, females 19.8-155.2

    Time frame: Through study completion, an average of 4 months

  3. differences in peripheral tissue markers of thyroid hormones by biochemical assays comparing study group and controls

    measurement of serum levels of ferritin - unit of measure: ng/mL, normal range: 25-400

    Time frame: Through study completion, an average of 4 months

  4. differences in peripheral tissue markers of thyroid hormones by biochemical assays comparing study group and controls

    measurement of serum levels of creatine phosphokinase (CPK) - unit of measure: U/L, normal range: 10-71

    Time frame: Through study completion, an average of 4 months

  5. differences in peripheral tissue markers of thyroid hormones by biochemical assays comparing study group and controls

    measurement of serum levels of myoglobin - unit of measure: ng/mL, normal range: 15-106

    Time frame: Through study completion, an average of 4 months

  6. differences in peripheral tissue markers of thyroid hormones by biochemical assays comparing study group and controls

    measurement of serum levels of osteocalcin - unit of measure: ng/mL, normal range: 4.6-65.4

    Time frame: Through study completion, an average of 4 months

  7. differences in peripheral tissue markers of thyroid hormones by biochemical assays comparing study group and controls

    measurement of serum levels of angiotensin-converting enzyme (ACE) - unit of measure: U/L, normal range: 8-52

    Time frame: Through study completion, an average of 4 months

  8. differences in thyroid hormones by biochemical assays comparing study group and controls

    measurement of serum levels of free triiodothyronine (fT3) - unit of measure: pg/mL, normal range: 1.7-3.7; measurement of serum levels of free thyroxine (fT4) - unit of measure: pg/mL, normal range: 7-15

    Time frame: Through study completion, an average of 4 months

07

Study locations

No study locations are listed for this record.

08

References and documents

Publications

  • Spaggiari G, Brigante G, De Vincentis S, Cattini U, Roli L, De Santis MC, Baraldi E, Tagliavini S, Varani M, Trenti T, Rochira V, Simoni M, Santi D. Probiotics Ingestion Does Not Directly Affect Thyroid Hormonal Parameters in Hypothyroid Patients on Levothyroxine Treatment. Front Endocrinol (Lausanne). 2017 Nov 14;8:316. doi: 10.3389/fendo.2017.00316. eCollection 2017. PubMed 29184537 ↗

Individual participant data

Plan to share: Undecided

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Mar 30, 2017, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03095963
Lead sponsor
Azienda USL Modena
Responsible party
Manuela Simoni (Director of Unit of Endocrinology, Department of Medicine, Endocrinology, Metabolism and Geriatrics, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy, Azienda USL Modena) — Principal investigator
First posted
Mar 30, 2017
Start date
Jan 1, 2014
Primary completion
Oct 25, 2016
Completion
Oct 25, 2016
Last update
Mar 30, 2017

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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