Thyroxine replacement: a clinical endocrinologist’s viewpoint

Eligar, Vinay; Taylor, Peter N.; Okosieme, Onyebuchi; Leese, Graham; Dayan, Colin

doi:10.1177/0004563216642255

Cited by 55 publications

(38 citation statements)

References 121 publications

(207 reference statements)

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“…Among the patients ( n = 116) submitted to the outpatient clinic due to persistent symptoms, 43% did not start combination therapy due to being overtreated with a S-TSH less than 0.1 mU/L or undertreated with a S-TSH of 4-56 mU/L -this is in accordance with Eligar et al [18] , underlining the importance of careful follow-up and adjustment of medication in this patient group.…”

Section: Discussionsupporting

confidence: 82%

Neither Baseline nor Changes in Serum Triiodothyronine during Levothyroxine/Liothyronine Combination Therapy Predict a Positive Response to This Treatment Modality in Hypothyroid Patients with Persistent Symptoms

et al. 2017

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Background: Despite biochemical euthyroidism, some levothyroxine (L-T₄)-treated hypothyroid patients report persisting symptoms and some of these patients are tentatively treated with a combination of L-T₄ and liothyronine (L-T₃). Combination therapy and the appropriate choice of blood tests to monitor treatment are highly debated among specialists and patients. Aim: To evaluate whether measuring serum triiodothyronine (S-T₃) at baseline or during combination therapy can be used as an indicator of a positive effect from L-T₄/L-T₃ combination therapy. Materials and Methods: Observational retrospective study of patients (n = 42) with persisting symptoms of hypothyroidism despite L-T₄ therapy who had normal TSH levels and did not have any comorbidities that could explain their symptoms. All were then treated with L-T₄/L-T₃ combination therapy at a dose ratio of 17/1 according to European Thyroid Association guidelines. Based on patient-reported outcome, they were divided into responders and nonresponders. Results: Five patients were lost to follow-up and thus excluded. At the 3-month follow-up, 11 were classified as nonresponders and 26 as responders. At 12 months these figures had changed to 13 (35%) and 24 (65%), respectively. When comparing responders versus nonresponders, no differences were seen at baseline or during follow-up in S-T₃ and in free T₃ estimates. Further, logistic regression showed no correlation between S-T₃ and free T₃ estimates and responder/nonresponder status. Conclusion: Our data indicate that serum T₃ measurements are not suitable to predict which patient will benefit from L-T₄/L-T₃ combination therapy, and treatment response cannot be followed by repeated T₃ measurements either.

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Section: Discussionsupporting

confidence: 82%

Neither Baseline nor Changes in Serum Triiodothyronine during Levothyroxine/Liothyronine Combination Therapy Predict a Positive Response to This Treatment Modality in Hypothyroid Patients with Persistent Symptoms

et al. 2017

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“…In 2008, the Endocrine Society has published a position statement on this issue to ensure pharmacologic homeostasis of patients (https://www.endocrine.org/advocacy/priorities-andpositions/bioequivalence-of-sodium-levothyroxine). There is, however, general consensus that switching between different tablet T4 preparation should be avoided (2,9).…”

Section: How the Pharmaceutical Forms Of Oral Thyroxine Are Preparedmentioning

confidence: 99%

“…However, the number of interfering issues rendered often inadequate for a patient a dose that is satisfactory for another (8). It has been reported that 20% to 50% of patients fail to show a complete chemical and/or clinical response to a reference dose of thyroxine (9). The consequence of that is the need for an increased dose, care and monitoring (10).…”

Section: Introductionmentioning

confidence: 99%

Gastrointestinal Malabsorption of Thyroxine

et al. 2018

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at the modification stage), and do not reflect editorial changes. No corrections/changes to the PDF manuscripts are accepted. Accordingly, there likely will be differences between the Advance Article manuscripts and the final, typeset articles. The manuscripts remain listed on the Advance Article page until the final, typeset articles are posted. At that point, the manuscripts are removed from the Advance Article page. DISCLAIMER: These manuscripts are provided "as is" without warranty of any kind, either express or particular purpose, or non-infringement. Changes will be made to these manuscripts before publication. Review and/or use or reliance on these materials is at the discretion and risk of the reader/user. In no event shall the Endocrine Society be liable for damages of any kind arising references to, products or publications do not imply endorsement of that product or publication.

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“…Individuals with this disease are commonly managed through supplementation with synthetic thyroid hormone, with the aim of alleviating symptoms and restoring normal thyroid-stimulating hormone levels [7] Levothyroxine, the treatment of choice, is inexpensive, easy to administer and in most cases restores well-being while normalizing thyroid function. However, 30-50% of individuals on levothyroxine are either over-treated or undertreated, and others remain dissatisfied with treatment despite achieving thyroid hormone concentrations within the laboratory reference interval [8]. Treatment with constitutional homoeopathic medicine alone or along with levothyroxine leads to the cure of hypothyroidism.…”

Section: Discussionmentioning

confidence: 99%

Response of Hypothyroidism to Homeopathic Treatment: A Report of Three Cases

Dogra¹,

Mandal²

2020

Innovare J Med Sci

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Objectives:Hypothyroidism is a disease in which the thyroid gland does not produce enough thyroid hormone.It is the second most common endocrine disorder among women.Common causes are autoimmune disease such as Hashimoto’s thyroiditis, surgical removal of the thyroid and radiation therapy.Symptoms of Hypothyroidism include weight gain, alteration in cognition, fatigue, infertility and menstrual abnormalities.Thyroid stimulating hormone is highly sensitive to thyroid dysfunction and is used to evaluate thyroid disorders.Monotherapy with Levothyroxine is the standard for treating hypothyroidism in the conventional method.Apart from coventional method of treatment homoeopathy also has a scope in the treatment of hypothyroidism. Methods: This is a series of three cases which presented with symptoms of Hypothyroidism thoroughly evaluated and treated with constitutional homoeopathic medicine in a variable period of time.Assesment of thyroid stimulating hormone was done to see the improvement in the cases . Results: A marked improvement in the clinical symptoms as well as the pathological report was observed. Conclusion: This case series shows that Homoeopathic intervention can be used in the treatment of Hypothyroidism.

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Thyroxine replacement: a clinical endocrinologist’s viewpoint

Abstract: Despite the availability of thyroid hormone replacement for more than a century, there are still substantial challenges in practice and opportunities to improve treatment outcomes.

Cited by 55 publications

References 121 publications

Neither Baseline nor Changes in Serum Triiodothyronine during Levothyroxine/Liothyronine Combination Therapy Predict a Positive Response to This Treatment Modality in Hypothyroid Patients with Persistent Symptoms

Neither Baseline nor Changes in Serum Triiodothyronine during Levothyroxine/Liothyronine Combination Therapy Predict a Positive Response to This Treatment Modality in Hypothyroid Patients with Persistent Symptoms

Gastrointestinal Malabsorption of Thyroxine

Response of Hypothyroidism to Homeopathic Treatment: A Report of Three Cases

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