80 results match your criteria frequency lt4

Use of Statins Among Patients Taking Levothyroxine: an Observational Drug Utilization Study Across Sites.

J Endocr Soc 2021 Jul 6;5(7):bvab038. Epub 2021 Mar 6.

Section of Adult and Pediatric Endocrinology and Metabolism, University of Chicago, Chicago, IL 60637, USA.

Context: Treatment with levothyroxine (LT4) that normalize serum thyrotropin (TSH) is expected to restore lipid metabolism.

Objective: To assess statin utilization in LT4-treated patients through an observational drug utilization study.

Methods: Three sites were involved: (1) 10 723 outpatients placed on LT4 during 2006-2019 identified from the Clinical Research Data Warehouse of the University of Chicago; (2) ~1. Read More

View Article and Full-Text PDF

Frequency of Thyroid Hormone Replacement After Lobectomy for Differentiated Thyroid Cancer.

Endocr Pract 2021 Jul 15;27(7):691-697. Epub 2021 Jan 15.

Section of Endocrine Surgery, Department of Surgery, UCLA David Geffen School of Medicine, Los Angeles, California.

Objective: To determine the frequency of levothyroxine (LT4) supplementation after therapeutic lobectomy for low-risk differentiated thyroid cancer (DTC).

Methods: This retrospective cohort study enrolled adult patients with low-risk DTC confirmed using surgical pathology who underwent therapeutic lobectomy at a single institution from January 2016 through May 2020. The outcome measures were postoperative serum thyroid-stimulating hormone (TSH) levels and the initiation of LT4. Read More

View Article and Full-Text PDF

Quality of Life in Patients with Low-Risk Papillary Thyroid Microcarcinoma: Active Surveillance Versus Immediate Surgery.

Endocr Pract 2020 Dec;26(12):1451-1457

From the Center for Excellence in Thyroid Care, Kuma Hospital, Kobe, Japan.

Objective: This study aimed to compare the quality of life (QoL) and psychological issues of patients with papillary thyroid microcarcinoma (PMC) who were under active surveillance (AS) and those who underwent immediate surgery (OP).

Methods: This was a cross-sectional study conducted on 347 patients with low-risk PMC who were under AS (n = 298) or who underwent OP (n = 49). They were asked to complete two questionnaires (thyroid cancer-specific health-related QoL [THYCA-QoL] and the Hospital Anxiety and Depression Scale [HADS]). Read More

View Article and Full-Text PDF
December 2020

Clinical Outcomes After Discontinuation of Thyroid Hormone Replacement: A Systematic Review and Meta-Analysis.

Thyroid 2021 05 29;31(5):740-751. Epub 2020 Dec 29.

Division of Endocrinology and Metabolism, Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.

Levothyroxine (LT4) is one of the most commonly prescribed medications. Although considered a life-long replacement therapy, LT4 therapy can be discontinued for some patients. This study aims at: (i) reviewing the evidence on clinical outcomes of patients undergoing thyroid hormone replacement discontinuation, (ii) identifying the predictors of successful discontinuation, and (iii) systematically appraising frameworks used for deprescribing thyroid hormone. Read More

View Article and Full-Text PDF

Conservative treatment of fetal dyshormonogenetic goiter with levothyroxine, a systematic literature review.

Exp Ther Med 2020 Sep 26;20(3):2434-2438. Epub 2020 May 26.

Department of Obstetrics and Gynecology, Queen Elizabeth II Hospital, Grande Prairie, AB T8V 2E8, Canada.

Fetal goitrous hypothyroidism is a rare condition associated with important obstetrical, neonatal complications, and neurodevelopmental impairments. Prenatal treatment remains controversial, and the risk to benefit ratio must be accurately assessed and considered for individualized management. The objective of this review was to evaluate the feasibility, safety, and effectiveness of the conservative treatment of fetal goitrous hypothyroidism. Read More

View Article and Full-Text PDF
September 2020

Individualized Therapy for Hypothyroidism: Is T4 Enough for Everyone?

J Clin Endocrinol Metab 2020 09;105(9)

Section of Adult and Pediatric Endocrinology and Metabolism, University of Chicago, Chicago, Illinois, USA.

Context: It is well recognized that some hypothyroid patients on levothyroxine (LT4) remain symptomatic, but why patients are susceptible to this condition, why symptoms persist, and what is the role of combination therapy with LT4 and liothyronine (LT3), are questions that remain unclear. Here we explore evidence of abnormal thyroid hormone (TH) metabolism in LT4-treated patients, and offer a rationale for why some patients perceive LT4 therapy as a failure.

Evidence Acquisition: This review is based on a collection of primary and review literature gathered from a PubMed search of "hypothyroidism," "levothyroxine," "liothyronine," and "desiccated thyroid extract," among other keywords. Read More

View Article and Full-Text PDF
September 2020

Differences in food consumption between patients with Hashimoto's thyroiditis and healthy individuals.

Sci Rep 2020 06 30;10(1):10670. Epub 2020 Jun 30.

Department of Medical Biology, University of Split School of Medicine, Soltanska 2, 21000, Split, Croatia.

Food is considered as important environmental factor that plays a role in development of Hashimoto's thyroiditis (HT). The goal of our study was to identify food groups, assessed by food frequency questionnaire, that differ in consumption frequency between 491 patients with HT and 433 controls. We also analysed association of food groups with the wealth of HT-related clinical traits and symptoms. Read More

View Article and Full-Text PDF

Trabecular bone deterioration in differentiated thyroid cancer: Impact of long-term TSH suppressive therapy.

Cancer Med 2020 08 25;9(16):5746-5755. Epub 2020 Jun 25.

Service of Endocrinology, University Hospital 12 de Octubre, Madrid, Spain.

Background: Conflicting results has been reported regard osteoporosis and fractures in patients with Differentiated Thyroid Cancer (DTC). Our objective was to evaluate the long-term effects of TSH suppression therapy with Levothyroxine (LT4) on trabecular bone score (TBS) and bone mineral density (BMD) in females with DTC after thyroidectomy.

Methods: About 145 women with resected DTC and receiving long-term TSH therapy, were stratified according to the degree of TSH suppression. Read More

View Article and Full-Text PDF

Effect of Thyroid Hormone Therapy on Fatigability in Older Adults With Subclinical Hypothyroidism: A Nested Study Within a Randomized Placebo-Controlled Trial.

J Gerontol A Biol Sci Med Sci 2020 09;75(9):e89-e94

Institute of Primary Health Care (BIHAM), University of Bern, Switzerland.

Background: Fatigue often triggers screening for and treatment of subclinical hypothyroidism. However, data on the impact of levothyroxine on fatigue is limited and previous studies might not have captured all aspects of fatigue.

Method: This study is nested within the randomized, placebo-controlled, multicenter TRUST trial, including community-dwelling participants aged ≥65 and older, with persistent subclinical hypothyroidism (TSH 4. Read More

View Article and Full-Text PDF
September 2020

Compared with classic Hashimoto's thyroiditis, chronic autoimmune serum-negative thyroiditis requires a lower substitution dose of L-thyroxine to correct hypothyroidism.

J Endocrinol Invest 2020 Nov 21;43(11):1631-1636. Epub 2020 Apr 21.

Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100, Pavia, Italy.

Purpose: Serum-negative-chronic-autoimmune-thyroiditis (SN-CAT) is considered a milder variant of classic Hashimoto's thyroiditis (CHT). However, its prevalence remains unknown and it is still unclear whether SN-CAT behaves differently in terms of L-thyroxine (LT4) substitution treatment of hypothyroidism. Aims of this study were to estimate the prevalence of SN-CAT in a large series of hypothyroid patients and to compare LT4 requirements in hypothyroid patients with SN-CAT and CHT. Read More

View Article and Full-Text PDF
November 2020

Postpartum Thyroiditis in Women With Euthyroid and Hypothyroid Hashimoto's Thyroiditis Antedating Pregnancy.

J Clin Endocrinol Metab 2020 07;105(7)

Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.

Context: Postpartum thyroiditis (PPT) is defined as the occurrence of de novo autoimmune thyroid disease accompanied by thyroid dysfunction in the first year postpartum. However, hormonal changes resembling the typical pattern of PPT have been reported to occur even in women with pregestational Hashimoto's thyroiditis (HT) on levothyroxine (LT4).

Objective: To evaluate the risk of PPT in women with HT antedating pregnancy. Read More

View Article and Full-Text PDF

Effects of oral contraceptives on thyroid function and vice versa.

J Endocrinol Invest 2020 Sep 26;43(9):1181-1188. Epub 2020 Mar 26.

Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia 78, 95123, Catania, Italy.

Background: Thyroid gland dysfunction represents an epidemiologically relevant disease in the female gender, where treatment with oral contraceptives (OCs) is frequently prescribed. Although OCs are able to impact the thyroid gland function, scanty data have been released on this matter so far.

Aim: The aim of this article was to review how hormonal OCs, including estrogen- or progesterone-only containing medications, interact with the hepatic production of thyroid-binding globulin (TBG) and, consequently, their effects on serum levels of thyroxine (T4) and triiodothyronine (T3). Read More

View Article and Full-Text PDF
September 2020

Effect of antithyroid antibodies on women with recurrent miscarriage: A meta-analysis.

Am J Reprod Immunol 2020 06 11;83(6):e13238. Epub 2020 Apr 11.

Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Problem: The effect of thyroid autoimmunity (TAI) on the prevalence of recurrent miscarriage (RM) is highly debatable. No meta-analysis has been published in the past decade to investigate the impact of TAI on women with RM.

Method Of Study: Systemic literature search was conducted on PubMed, Embase, Cochrane, and Web of Science databases. Read More

View Article and Full-Text PDF

Impact of a Forced Dose-Equivalent Levothyroxine Brand Switch on Plasma Thyrotropin: A Cohort Study.

Thyroid 2020 06 4;30(6):821-828. Epub 2020 May 4.

Department of Endocrinology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

Patients with primary hypothyroidism are treated with levothyroxine (LT4) to normalize their serum thyrotropin (TSH). Finding the optimal dosage is a long-lasting process, and a small change can have major impact. Currently, limited data are available on the impact of dose-equivalent substitution between brands. Read More

View Article and Full-Text PDF

Systemic Thyroid Hormone Status in Treated Graves' Disease.

Int J Endocrinol Metab 2019 Oct 12;17(4):e95385. Epub 2019 Oct 12.

Department of Epidemiology and Biostatistics, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Objectives: We aimed to compare the markers of thyroid hormone status in treated euthyroid Graves' patients and levothyroxine (LT4)-treated hypothyroid Graves' patients.

Methods: We collected the data of 277 patients, including 140 radioiodine-treated hypothyroid Graves' patients on LT4 treatment (group 1), 83 euthyroid Graves' patients on methimazole (MMI) therapy (group 2), and 54 euthyroid Graves' patients off MMI or radioiodine therapy for > 2 years (group 3). After the exclusion of diabetic patients, 130, 73, and 52 patients remained for analysis in groups 1, 2, and 3, respectively. Read More

View Article and Full-Text PDF
October 2019

Prevalence of gastrointestinal disorders having an impact on tablet levothyroxine absorption: should this formulation still be considered as the first-line therapy?

Endocrine 2020 02 17;67(2):281-290. Epub 2020 Jan 17.

Clinic for Nuclear Medicine and Competence Center for Thyroid Diseases, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.

Purpose: In patients with hypothyroidism, levothyroxine (LT4) is the treatment of choice, and tablets are the most commonly prescribed formulation. Despite multiple scenarios being reported in the literature with impaired tablet absorption and likely missed TSH targets, it is yet unclear what the implications are for clinical practice and the role of liquid solution (LS) and soft gel (SG) formulations. We have thus conducted a narrative review evaluating the prevalence within the general population of gastrointestinal disorders impacting tablet LT4 absorption. Read More

View Article and Full-Text PDF
February 2020

Skeletal Effects of Levothyroxine for Subclinical Hypothyroidism in Older Adults: A TRUST Randomized Trial Nested Study.

J Clin Endocrinol Metab 2020 01;105(1)

Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.

Context: Both thyroid dysfunction and levothyroxine (LT4) therapy have been associated with bone loss, but studies on the effect of LT4 for subclinical hypothyroidism (SHypo) on bone yielded conflicting results.

Objective: To assess the effect of LT4 treatment on bone mineral density (BMD), Trabecular Bone Score (TBS), and bone turnover markers (BTMs) in older adults with SHypo.

Design And Intervention: Planned nested substudy of the double-blind placebo-controlled TRUST trial. Read More

View Article and Full-Text PDF
January 2020

Thyroid hormone therapy of hypothyroidism in pregnancy.

Endocrine 2019 10 15;66(1):35-42. Epub 2019 Oct 15.

Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, China Medical University, 110001, Shenyang, Liaoning, People's Republic of China.

Hypothyroidism is the most frequent pregnancy-related thyroid dysfunction, including overt and subclinical hypothyroidism. Studies show that even mild hypothyroidism may eventuate in adverse gestational outcomes and intellectual impairment of offspring. Women with overt hypothyroidism (OH) must be treated by levothyroxine (LT4) pre- and during pregnancy, however, it is controversial that when and how to initiate LT4 therapy and further optimize dosing so that pregnant women and their offspring may truly benefit. Read More

View Article and Full-Text PDF
October 2019

Levothyroxine Dosage as Predictor of Permanent and Transient Congenital Hypothyroidism: A Multicenter Retrospective Study in Japan.

Horm Res Paediatr 2019 25;92(1):45-51. Epub 2019 Sep 25.

Division of Endocrinology and Metabolism, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.

Background: Congenital hypothyroidism (CH) can be divided into 2 types, transient CH (T-CH) and permanent CH (P-CH), depending on the requirement of levothyroxine (LT4) for life-long treatment. Several studies have recently reported that the LT4 dosage is useful for predicting the LT4 requirement, but none of the studies followed their patients to puberty.

Objective: To determine the cutoff value for the LT4 dosage as a predictor of the LT4 requirement after puberty in patients with CH. Read More

View Article and Full-Text PDF

Levothyroxine treatment and pregnancy outcomes in women with subclinical hypothyroidism: a systematic review and meta-analysis.

Arch Gynecol Obstet 2019 10 10;300(4):805-819. Epub 2019 Aug 10.

Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Purpose: To evaluate the benefits of LT4 treatment on pregnancy outcomes in SCH women.

Study Design: PubMed [including Medline], Web of Science, Wiley, Google Scholar, Science direct and Scopus were searched for identifying and retrieving all English articles published up to May 2018 on the effects of levothyroxine treatment on pregnancy outcomes in pregnant women with SCH compared to untreated or healthy controls. In this systematic review and meta-analysis, both fixed and random effect models were applied to estimate the pooled effect size. Read More

View Article and Full-Text PDF
October 2019

Pycnogenol® prevents oxidative stress and side effects in patients with hypothyroidism during levothyroxine treatment.

Minerva Endocrinol 2019 Jun;44(2):199-204

IRVINE3 Labs, Chieti-Pescara University, Chieti, Italy.

Background: In this study we aimed to evaluate the efficacy of Pycnogenol® supplementation in controlling oxidative stress levels and in reducing the frequency and severity of side effects of levothyroxine (LT4) treatment in patients who had recently started this therapy.

Methods: The registry included 60 females affected by primary hypothyroidism with multi-nodular goiter. LT4 was administered at the dosage of 100 μg/day. Read More

View Article and Full-Text PDF

Overt and Subclinical Hypothyroidism in the Elderly: When to Treat?

Front Endocrinol (Lausanne) 2019 22;10:177. Epub 2019 Mar 22.

Geriatrics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

Hypothyroidism is characterized by increased thyrotropin (TSH) levels and reduced free thyroid hormone fractions while, subclinical hypothyroidism (sHT) by elevated serum TSH in the face of normal thyroid hormones. The high frequency of hypothyroidism among the general population in Western Countries made levothyroxine (LT4) one of the 10 most prescribed drugs. However, circulating TSH has been demonstrated to increase with aging, regardless the existence of an actual thyroid disease. Read More

View Article and Full-Text PDF

EMPATHY: A New Tool for Identifying the Most Suitable Thyroxine Formulation in Hypothyroid Patients.

Thyroid 2019 07 21;29(7):928-933. Epub 2019 May 21.

2Diabetes Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "L. Vanvitelli," Naples, Italy.

Therapy of hypothyroidism is based on the administration of appropriate doses of levothyroxine (LT4). A failure to achieve the thyrotropin (TSH) target may be due to poor compliance with the LT4 therapy in about 60% of cases or to malabsorption in about 40% of cases. No tools are available for detecting malabsorption disorders before the choice of the most appropriate therapy. Read More

View Article and Full-Text PDF

Predictive Ability of a Laboratory Performance Test in Mountain Bike Cross-country Olympic Athletes.

Int J Sports Med 2019 May 1;40(6):397-403. Epub 2019 Apr 1.

Department of Sports Medicine, Medical Clinic, University of Tuebingen, Tuebingen.

Mountain bike Cross-Country Olympic (XCO) has an intermittent performance profile, underlining the importance of anaerobic metabolism. Traditional performance tests in cycling primarily quantify aerobic metabolism and inadequately meet the demands in XCO. The aim was therefore to validate a specific test that quantifies these requirements by means of an XCO race. Read More

View Article and Full-Text PDF

Evaluation of the impact of levothyroxine treatment on the psychomotor developmental status of three-year-old children born to mothers with mild thyroid impairment; Tehran Thyroid and pregnancy study: study protocol for a randomized clinical trial.

Trials 2019 Jan 28;20(1):86. Epub 2019 Jan 28.

Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Despite the known adverse effects of maternal overt hypothyroidism on the neurocognitive development of children, there is uncertainty regarding the impact of gestational thyroid dysfunction or autoimmune thyroiditis on infant/child neurological development. This study aims to evaluate the impact of levothyroxine (LT4) treatment on the psychomotor developmental status of three-year-old children born to mothers with mild thyroid impairment (subclinical hypothyroidismwith/without autoimmune thyroiditis).

Methods/design: This is a follow-up study of the Tehran Thyroid and Pregnancy Study, a randomized trial in which subclinical hypothyroid pregnant women were assigned to an intervention group (treated with levothyroxine) or a control group (received no treatment). Read More

View Article and Full-Text PDF
January 2019

Thyroglobulin Antibodies are Associated with Symptom Burden in Patients with Hashimoto's Thyroiditis: A Cross-Sectional Study.

Immunol Invest 2019 Feb 17;48(2):198-209. Epub 2018 Oct 17.

b Department of Medical Biology , University of Split, School of Medicine , Split , Croatia.

Background: Hashimoto's thyroiditis (HT) is the most common form of autoimmune thyroid disorders characterized by lower production of thyroid hormones and positivity to autoantibodies to thyroglobulin (TgAb) and/or thyroid peroxidase (TPOAb). We performed a comprehensive phenotypic characterization of patients with HT, with specific focus on thyroid autoimmunity, to get better understanding of disease manifestation.

Methods: We collected information on thyroid-specific phenotypes (TSH, T3, T4, fT4, TgAb, TPOAb, thyroid volume) and other clinical phenotypes (age, body surface area, number of hypothyroidism symptoms, blood pressure) from 290 patients with HT without levothyroxine (LT4) therapy with the aim to test for correlations between thyroid-specific and clinical phenotypes. Read More

View Article and Full-Text PDF
February 2019

Patients on levothyroxine replacement in the community: association between hypothyroidism symptoms, co-morbidities and their quality of life.

Fam Pract 2019 05;36(3):269-275

Department of Endocrinology, Changi General Hospital, Singapore.

Introduction: Patients may be symptomatic, resulting in lower quality of life (QOL), despite L-thyroxine (LT4) therapy for hypothyroidism or having normal thyroid function. We hypothesized that their clinical symptoms of hypothyroidism and co-morbidities were associated with QOL.

Objective: The study aimed to determine the association between the hypothyroid-related symptoms of Asian patients on LT4 treatment, their co-morbidities and their QOL. Read More

View Article and Full-Text PDF

The Effect of the Bariatric Surgery Type on the Levothyroxine Dose of Morbidly Obese Hypothyroid Patients.

Obes Surg 2018 11;28(11):3538-3543

Service of Endocrinology, Diabetes and Metabolism of Centro Hospitalar de São João, EPE, Porto, Portugal.

Background: Doubts exist about the effect of different bariatric surgery (BS) types on levothyroxine (Lt4) absorption. We compared Lt4 doses and their variation (ΔLt4) in patients with hypothyroidism that underwent malabsorptive (MS) or restrictive (RS) surgery and studied predictors of Lt4 dose change.

Methods: Retrospective study of morbidly obese hypothyroid patients submitted to BS. Read More

View Article and Full-Text PDF
November 2018

Clinical utility of an ultrasensitive thyroglobulin assay in the follow-up of patients with differentiated thyroid cancer: can the stimulation test be avoided in patients with an intermediate recurrence risk?

Acta Otorhinolaryngol Ital 2018 Jun;38(3):188-193

Central Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", México City, México.

Summary: Serum thyroglobulin (Tg) measurement during suppression with levothyroxine (LT4) using an ultrasensitive assay (OnT4-Tg) has been proposed as a replacement of TSH-stimulated Tg measurement (OffT4-Tg) in management of patients with differentiated thyroid cancer (DTC). The aim of this study is to evaluate the capacity of an ultrasensitive Tg assay in predicting an OffT4-Tg > 2.0 ng/mL based on the OnT4-Tg in patients with DTC and an intermediate recurrence risk. Read More

View Article and Full-Text PDF

Early Determinants of Thyroid Function Outcomes in Children with Congenital Hypothyroidism and a Normally Located Thyroid Gland: A Regional Cohort Study.

Thyroid 2018 08 30;28(8):959-967. Epub 2018 Jul 30.

1 Department of Pediatric Endocrinology Diabetology, Reference Centre for Endocrine Growth and Development Diseases, Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital , Paris, France .

Background: An increase in the incidence of congenital hypothyroidism (CH) with a normally located gland has been reported worldwide. Affected individuals display transient or permanent CH during follow-up in childhood. This study aimed to determine the prevalence of transient CH and to investigate the possibility of distinguishing between transient and permanent CH in early infancy. Read More

View Article and Full-Text PDF