JAMA
One in four older adults may safely stop long-term levothyroxine, study finds
In this prospective, single-group study of 370 community-dwelling adults aged ≥60 years, more than one-quarter were able to successfully discontinue levothyroxine while maintaining acceptable thyroid function for 1 year. Overall, 26% maintained a TSH <10 mIU/L and normal free T4 after stepwise dose reduction, with the highest success seen in those on low doses: 64% of patients taking ≤50 µg/day discontinued therapy without clinically meaningful declines in thyroid-related quality of life or symptom burden. The findings suggest that some older adults—particularly those with unclear or historical indications—may be overtreated.
As the authors note, “evaluation of the need to continue treatment with levothyroxine should be considered in adults aged 60 years or older.”
Clinical takeaway: For clinically stable adults ≥60 years with TSH <10 mIU/L—especially those taking ≤50 µg/day—consider a supervised, stepwise trial of levothyroxine deprescribing with close lab monitoring.
Source: Ravensberg J, et al. (2026, April 6). JAMA. Discontinuation of Levothyroxine in Adults Aged 60 Years or Older