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Use of Thyroid Hormones in Hypothyroid and Euthyroid Patients : A 2020 THESIS Questionnaire Survey of Members of the Swedish Endocrine Society

Planck, Tereza LU ; Lantz, Mikael LU ; Perros, Petros ; Papini, Enrico ; Attanasio, Roberto ; Nagy, Endre V. and Hegedüs, Laszlo (2021) In Frontiers in Endocrinology 12.
Abstract

Background: The standard treatment of hypothyroidism is levothyroxine (LT-4). However, there are several controversies regarding treatment of hypothyroid patients. Aim: To investigate the Swedish endocrinologists’ use of thyroid hormones in hypothyroid and euthyroid individuals. Methods: Physician members of the Swedish Endocrine Society (SEF) were invited by e-mail to participate in an online survey investigating this topic. Results: Out of the eligible 411 members, 116 (28.2%) responded. The majority (98.9%) stated that L-T4 is the treatment of choice. However, around 50% also prescribed liothyronine (L-T3) or a combination of L-T4+L-T3 in their practice. Combination therapy was mostly (78.5%) used in patients with persistent... (More)

Background: The standard treatment of hypothyroidism is levothyroxine (LT-4). However, there are several controversies regarding treatment of hypothyroid patients. Aim: To investigate the Swedish endocrinologists’ use of thyroid hormones in hypothyroid and euthyroid individuals. Methods: Physician members of the Swedish Endocrine Society (SEF) were invited by e-mail to participate in an online survey investigating this topic. Results: Out of the eligible 411 members, 116 (28.2%) responded. The majority (98.9%) stated that L-T4 is the treatment of choice. However, around 50% also prescribed liothyronine (L-T3) or a combination of L-T4+L-T3 in their practice. Combination therapy was mostly (78.5%) used in patients with persistent hypothyroid symptoms despite biochemical euthyroidism on L-T4 treatment. Most respondents prescribed L-T4 tablets and did not expect any major changes with alternative formulations such as soft-gel capsules or liquid formulations in situations influencing the bioavailability of L-T4. In euthyroid patients, 49.5% replied that treatment with thyroid hormones was never indicated, while 47.3% would consider L-T4 for euthyroid infertile women with high thyroid peroxidase (TPO) antibody levels. Conclusion: The treatment of choice for hypothyroidism in Sweden is L-T4 tablets. Combination therapy with L-T4+L-T3 tablets was considered for patients with persistent symptoms despite biochemical euthyroidism. Soft-gel capsules and liquid solutions of L-T4 were infrequently prescribed. Swedish endocrinologists’ deviation from endocrine society guidelines merits further study.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
desiccated thyroid extract (DTE), euthyroidism, hypothyroidism, levothyroxine, liothyronine, survey, Swedish Endocrine Society
in
Frontiers in Endocrinology
volume
12
article number
795111
publisher
Frontiers Media S. A.
external identifiers
  • scopus:85121987063
  • pmid:34938274
ISSN
1664-2392
DOI
10.3389/fendo.2021.795111
language
English
LU publication?
yes
id
0ce9c240-d133-4ab9-b22b-d0981d0b0790
date added to LUP
2022-02-04 13:18:28
date last changed
2024-04-10 09:02:09
@article{0ce9c240-d133-4ab9-b22b-d0981d0b0790,
  abstract     = {{<p>Background: The standard treatment of hypothyroidism is levothyroxine (LT-4). However, there are several controversies regarding treatment of hypothyroid patients. Aim: To investigate the Swedish endocrinologists’ use of thyroid hormones in hypothyroid and euthyroid individuals. Methods: Physician members of the Swedish Endocrine Society (SEF) were invited by e-mail to participate in an online survey investigating this topic. Results: Out of the eligible 411 members, 116 (28.2%) responded. The majority (98.9%) stated that L-T4 is the treatment of choice. However, around 50% also prescribed liothyronine (L-T3) or a combination of L-T4+L-T3 in their practice. Combination therapy was mostly (78.5%) used in patients with persistent hypothyroid symptoms despite biochemical euthyroidism on L-T4 treatment. Most respondents prescribed L-T4 tablets and did not expect any major changes with alternative formulations such as soft-gel capsules or liquid formulations in situations influencing the bioavailability of L-T4. In euthyroid patients, 49.5% replied that treatment with thyroid hormones was never indicated, while 47.3% would consider L-T4 for euthyroid infertile women with high thyroid peroxidase (TPO) antibody levels. Conclusion: The treatment of choice for hypothyroidism in Sweden is L-T4 tablets. Combination therapy with L-T4+L-T3 tablets was considered for patients with persistent symptoms despite biochemical euthyroidism. Soft-gel capsules and liquid solutions of L-T4 were infrequently prescribed. Swedish endocrinologists’ deviation from endocrine society guidelines merits further study.</p>}},
  author       = {{Planck, Tereza and Lantz, Mikael and Perros, Petros and Papini, Enrico and Attanasio, Roberto and Nagy, Endre V. and Hegedüs, Laszlo}},
  issn         = {{1664-2392}},
  keywords     = {{desiccated thyroid extract (DTE); euthyroidism; hypothyroidism; levothyroxine; liothyronine; survey; Swedish Endocrine Society}},
  language     = {{eng}},
  month        = {{12}},
  publisher    = {{Frontiers Media S. A.}},
  series       = {{Frontiers in Endocrinology}},
  title        = {{Use of Thyroid Hormones in Hypothyroid and Euthyroid Patients : A 2020 THESIS Questionnaire Survey of Members of the Swedish Endocrine Society}},
  url          = {{http://dx.doi.org/10.3389/fendo.2021.795111}},
  doi          = {{10.3389/fendo.2021.795111}},
  volume       = {{12}},
  year         = {{2021}},
}