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Mikael Lantz

Mikael Lantz

Consultant

Mikael Lantz

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

Author

  • Tereza Planck
  • Mikael Lantz
  • Petros Perros
  • Enrico Papini
  • Roberto Attanasio
  • Endre V. Nagy
  • Laszlo Hegedüs

Summary, in English

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.

Department/s

  • Genomics, Diabetes and Endocrinology
  • EXODIAB: Excellence of Diabetes Research in Sweden

Publishing year

2021-12-06

Language

English

Publication/Series

Frontiers in Endocrinology

Volume

12

Document type

Journal article

Publisher

Frontiers Media S. A.

Topic

  • Endocrinology and Diabetes

Keywords

  • desiccated thyroid extract (DTE)
  • euthyroidism
  • hypothyroidism
  • levothyroxine
  • liothyronine
  • survey
  • Swedish Endocrine Society

Status

Published

Research group

  • Genomics, Diabetes and Endocrinology

ISBN/ISSN/Other

  • ISSN: 1664-2392