Effects of Levothyroxine Adminstration and Withdrawal on the Hypothalamic-Pituitary-Thyroid Axis in Euthyroid Dogs

Background: Because of the vague clinical signs and limitations of thyroid function tests, misdiagnosis of hypothyroidism in dogs is common and leads to inappropriate treatment with levothyroxine. Chronic supplementation can suppress the hypothalamic-pituitary-thyroid axis (HPTA) and make it difficult to assess thyroid function following withdrawal of levothyroxine.

Objectives: To determine if the HPTA is suppressed following levothyroxine administration in euthyroid dogs and the time required for resolution of any suppression.

Animals: Twenty-eight healthy euthyroid dogs

Methods: A prospective randomized study administering levothyroxine to euthyroid dogs with levothyroxine, for either 8 weeks (group 1) or 16 weeks (group 2). Serum concentrations of total thyroxine (T4), free thyroxine (fT4) by equilibrium dialysis, thyrotropin (TSH), and 3,5,3'-triiodothyronine (T3) were measured every 4 weeks during supplementation and for 16 weeks after levothyroxine was discontinued.

Results: Mean serum T4 and fT4 were significantly higher and TSH was lower in all dogs during levothyroxine administration compared to baseline. Mean serum concentrations of T4 and fT4 in both groups and TSH in group 1, beginning 1 week after levothyroxine was discontinued, were significantly different compared to values during levothyroxine administration but not compared to baseline values.

Conclusions and Clinical Importance: Suppression of the HPTA occurred during levothyroxine supplementation and mean serum T4, fT4 and TSH concentrations were not significantly different compared to baseline 1 week after discontinuation in both groups. Assessing thyroid function tests 1 week after cessation of levothyroxine will likely provide an accurate assessment of thyroid function in euthyroid dogs.