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18.07.2024 | 8:05 PM
Thyroid Hormone Homeostasis in Levothyroxine-treated Patients: Findings From ELSA-Brasil
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Context: The effectiveness of levothyroxine (LT4) in restoring thyroid hormone (TH) homeostasis, particularly serum thyroxine (T4) and triiodothyronine (T3) levels, remains debatable.Objective: This work aimed to assess TH homeostasis in LT4-treated individuals using data from the Longitudinal Study of Adult Health in Brazil (ELSA-Brasil) study.Methods: The ELSA-Brasil study follows 15 105 adult Brazilians (aged 35-74 […]

18.07.2024 | 7:50 PM
A Cross-Sectional Analysis of Cardiovascular and Bone Health Care Utilization During Treatment With Thyroid Hormone
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Context: Combination therapy with levothyroxine and liothyronine (LT4 + LT3) and desiccated thyroid extract (DTE) make up >10% of new thyroid hormone (TH) prescriptions in the United States.Objective: To assess health care utilization related to cardiovascular disease (CVD) and bone health (BH) events (atrial fibrillation [AF], heart failure [HF], myocardial infarction [MI], stroke, and osteoporosis/fractures […]

18.07.2024 | 7:02 PM
Demographic, Healthcare Access, and Dietary Factors Associated With Thyroid Hormone Treatments for Hypothyroidism
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Context: Clinical guidelines have recommended a trial of liothyronine (LT3) with levothyroxine (LT4) in select patients with hypothyroidism. However, little is known about the real-world use of LT3 and desiccated thyroid extract (DTE) and the characteristics of patients treated with LT3 and DTE.Objectives: (1) Determine national trends of new LT4, LT3, and DTE prescriptions in […]

18.07.2024 | 6:49 PM
Levothyroxine Treatment Adequacy and Formulation Changes in Patients with Hypothyroidism: A Retrospective Study of Real-World Data From the United States
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Background: The prevalence of hypothyroidism (HT) has increased over time. To assess the effectiveness of treatment, we (1) studied thyrotropin (TSH) levels among patients receiving levothyroxine (LT4) and (2) determined the percentages of patients switching among LT4 formulations.Methods: Data on patients with HT receiving LT4 from the Optum Clinical and Claims Database were analyzed from […]

18.07.2024 | 2:45 PM
The Effects of Patient Characteristics on the Management of Subclinical Hypothyroidism: A Survey of Faculty and Trainees
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Objective: There is no universal approach to the management of subclinical hypothyroidism (SCH). This study was designed to determine the impact of patient characteristics on management decisions in SCH amongst physician faculty members and trainees.Methods: An online survey was distributed to faculty members and medical trainees (ie, interns, residents, and fellows) at multiple academic medical […]

18.07.2024 | 2:32 PM
Serum Thyrotropin and Triiodothyronine Levels in Levothyroxine-treated Patients
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Context: Small adjustments in levothyroxine (LT4) dose do not appear to provide clinical benefit despite changes in thyrotropin (TSH) levels within the reference range. We hypothesize that the accompanying changes in serum total triiodothyronine (T3) levels do not reflect the magnitude of the changes in serum TSH.Objective: This work aims to characterize the relationships of […]

18.07.2024 | 2:24 PM
Selpercatinib-Induced Hypothyroidism Through Off-Target Inhibition of Type 2 Iodothyronine Deiodinase
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Purpose: The development of the selective RET inhibitors selpercatinib and pralsetinib has revolutionized the treatment of metastatic progressive RET-mutant medullary thyroid carcinoma (MTC) and other RET-driven cancers, given their more favorable side-effect profile. The aim of this study is to investigate the mechanisms of selpercatinib-induced thyroid dysfunction in athyreotic patients with RET-mutant MTC and in […]

18.07.2024 | 2:15 PM
Suboptimal Thyroid Hormone Replacement Is Associated With Worse Hospital Outcomes
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Context: Many patients with hypothyroidism receive suboptimal treatment that may affect hospital outcomes.Objective: This work aimed to identify differences in hospital outcomes between patients with and without hypothyroidism.Methods: A retrospective cohort study, using the propensity score-based fine stratification method to balance covariates, was conducted using a large, US-based, commercial claims database from January 1, 2008 […]

18.07.2024 | 2:02 PM
Emerging Therapies in Hypothyroidism
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Levothyroxine (LT4) is effective for most patients with hypothyroidism. However, a minority of the patients remain symptomatic despite the normalization of serum thyrotropin levels. Randomized clinical trials including all types of patients with hypothyroidism revealed that combination levothyroxine and liothyronine (LT4+LT3) therapy is safe and is the preferred choice of patients versus LT4 alone. Many […]

18.07.2024 | 1:40 PM
Are We Restoring Thyroid Hormone Signaling in Levothyroxine-Treated Patients With Residual Symptoms of Hypothyroidism?
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Introduction: Levothyroxine (LT4) at doses that maintain the serum thyroid-stimulating hormone levels within the normal range constitutes the standard of care for the treatment of hypothyroidism. After a few months, this eliminates the signs and symptoms of overt hypothyroidism in the majority of patients, owing to the endogenous activation of thyroxine to triiodothyronine, the biologically […]