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Endokrynol Pol. 2021;72(5):498-504. doi: 10.5603/EP.a2021.0071. Epub 2021 Aug 11.

The impact of levothyroxine on thyroid autoimmunity and hypothalamic-pituitary-thyroid axis activity in men with autoimmune hypothyroidism and early-onset androgenetic alopecia.

Endokrynologia Polska

Robert Krysiak, Karolina Kowalcze, Bogdan Marek, Bogusław Okopień

Affiliations

  1. Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland. [email protected].
  2. Department of Paediatrics in Bytom, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland.
  3. Division of Pathophysiology, Department of Pathophysiology and Endocrinology, Medical University of Silesia, Zabrze, Poland.
  4. Endocrinological Ward, Third Provincial Hospital, Rybnik, Poland.
  5. Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland.

PMID: 34378784 DOI: 10.5603/EP.a2021.0071

Abstract

INTRODUCTION: Administration of testosterone or dehydroepiandrosterone to subjects with low levels of these hormones was found to reduce thyroid antibody titres. Male-pattern baldness is accompanied by mildly increased androgen levels. The present study was aimed at investigating whether early-onset androgenetic alopecia determines the impact of exogenous levothyroxine on thyroid autoimmunity and hypothalamic-pituitary-thyroid axis activity in young men with autoimmune hypothyroidism.

MATERIAL AND METHODS: The study included 2 thyroid-antibody-matched groups of men with autoimmune hypothyroidism: subjects with early-onset androgenetic alopecia (group 1; n = 24) and subjects with no evidence of hair loss (group 2; n = 24). All patients were treated with exogenous levothyroxine. Circulating titres of thyroid peroxidase and thyroglobulin antibodies, as well as levels of thyrotropin, free thyroxine, free triiodothyronine, prolactin, total testosterone, calculated bioavailable testosterone, dehydroepiandrosterone-sulphate, and oestradiol were measured before levothyroxine treatment and 6 months later.

RESULTS: In both study groups, levothyroxine decreased thyroid antibody titres, reduced thyrotropin levels and increased free thyroid hormone levels. However, these effects were less pronounced in the men with early-onset male-pattern baldness than in the control men. The degree of reduction in antibody titres and thyrotropin levels correlated with baseline levels of total and calculated bioavailable testosterone, as well with baseline insulin sensitivity and treatment-induced improvement in insulin sensitivity. Concentrations of the remaining variables remained unchanged throughout the study period.

CONCLUSIONS: The results of the current study suggest that the benefits of levothyroxine therapy in men with autoimmune hypothyroidism are less pronounced in individuals with early-onset androgenetic alopecia.

Keywords: androgenetic alopecia; hormones; hypothalamic–pituitary–thyroid axis; levothyroxine; thyroid autoimmunity

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