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. 2021 Nov;44(11):2435-2444.
doi: 10.1007/s40618-021-01555-y. Epub 2021 Mar 28.

Use of thyroid hormones in hypothyroid and euthyroid patients: A 2020 THESIS questionnaire survey of members of the Danish Endocrine Society

K R Riis  1 , J S Frølich  2 , L Hegedüs  2 , R Negro  3 , R Attanasio  4 , E V Nagy  5 , E Papini  6 , P Perros  7 , S J Bonnema  2
Affiliations

Use of thyroid hormones in hypothyroid and euthyroid patients: A 2020 THESIS questionnaire survey of members of the Danish Endocrine Society

K R Riis et al. J Endocrinol Invest. 2021 Nov.

Abstract

Purpose: The standard treatment of hypothyroidism is levothyroxine (LT4), which is available as tablets or soft-gel capsules in Denmark. This study aimed to investigate Danish endocrinologists' use of thyroid hormones in hypothyroid and euthyroid patients.

Methods: An e-mail with an invitation to participate in an online survey investigating practices about substitution with thyroid hormones was sent to all members of the Danish Endocrine Society (DES).

Results: Out of 488 eligible DES members, a total of 152 (31.2%) respondents were included in the analysis. The majority (94.1%) of responding DES members use LT4 as the treatment of choice. Other treatment options for hypothyroidism are also used, as 58.6% prescribe combination therapy with liothyronine (LT3) + LT4 in their clinical practice. LT4 + LT3 combination is preferred in patients with persistent symptoms of hypothyroidism despite biochemical euthyroidism on LT4 treatment. Over half of the respondents answered that thyroid hormone therapy is never indicated for euthyroid patients, but 42.1% will consider it for euthyroid infertile women with high antibody levels. In various conditions that could interfere with the absorption of LT4, most responding Danish endocrinologists prefer tablets and do not expect a significant difference when switching from one type of tablet formulation to another.

Conclusion: The treatment of choice for hypothyroidism is LT4. Combination therapy with LT4 + LT3 is considered for patients with persistent symptoms. Even in the presence of conditions affecting bioavailability, responding Danish endocrinologists prefer LT4 tablets rather than newer LT4 formulations, such as soft-gel capsules.

Keywords: Danish Endocrine Society; Euthyroidism; Hypothyroidism; Levothyroxine; Liothyronine; Survey.

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Conflict of interest statement

EVN, EP, PP, and LH have undertaken consultancy work for IBSA. All other authors have no conflicts of interest to declare that are relevant to the content of this article. IBSA had no role in the design of the survey, data analysis, data presentation, data interpretation, or writing the manuscript; the authors did not receive remuneration by IBSA.

Figures

Fig. 1
Fig. 1
Flowchart illustrating members of the Danish Endocrine Society and the Danish respondents of “Survey on Current Use of Levothyroxine in Europe”
Fig. 2
Fig. 2
Danish endocrinologists’ speculation concerning possible factors explaining persistent symptoms of hypothyroidism despite biochemical euthyroidism in patients treated with LT4
See this image and copyright information in PMC

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