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18.07.2024 | 8:05 PM

Thyroid Hormone Homeostasis in Levothyroxine-treated Patients: Findings From ELSA-Brasil

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

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

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

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

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

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

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

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 […]

20.03.2022 | 12:43 PM

Brain fog in hypothyroidism: understanding the patient’s perspective. PMID: 34890786

Patient-centered studies have shown that several patients on thyroid hormone replacement therapy for hypothyroidism exhibit persistent symptoms, including “brain fog.” In this study, we aimed to determine which of these specific symptoms are associated with brain fog, identify patient-reported factors that modify these symptoms, and identify patient concerns related to brain fog not included in […]

14.11.2018 | 1:54 PM

Persistently high cholesterol in hypothyroid patients treated with levothyroxine. PMID: 30124904

High blood cholesterol might be a sign of hypothyroidism. Indeed, patients with hypothyroidism typically have elevated cholesterol levels because thyroid hormone regulates cholesterol metabolism. Treatment of hypothyroidism with levothyroxine promptly reduces blood cholesterol, but does it return to normal levels? It has been assumed for years that normalization of TSH levels with levothyroxine also normalizes […]