Mifepristone Increases Thyroid Hormone Requirements in Patients With Central Hypothyroidism

A Multicenter Study

Francisco J. Guarda; James Findling; Kevin C.J. Yuen; Maria Fleseriu; Lisa B. Nachtigall


J Endo Soc. 2019;3(9):1707-1714. 

In This Article


Treatment with mifepristone in patients with Cushing syndrome can alter thyroid hormone levels, of which its effects on thyroid hormone metabolism remains poorly understood, especially in patients with concurrent CH. This case series of five patients with CD and CH, in whom increased levothyroxine requirements were observed after mifepristone initiation, suggest that close monitoring and adjustment of thyroid hormone replacement are necessary to optimize the management of these patients. More data are needed to determine its true prevalence and pathophysiology involved. Also, substantial weight loss was achieved in most cases, which is similar to the findings in the literature on mifepristone treatment in the long term.