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https://www.readbyqxmd.com/read/28324131/case-report-fast-reversal-of-severe-osteoporosis-after-correction-of-excessive-levothyroxine-treatment-and-long-term-follow-up
#1
C M Laine, K Landin-Wilhelmsen
This case report describes a 38-year-old woman, who presented with bilateral femoral stress fractures and osteoporosis after years of excessive levothyroxine treatment. Her bone health was restored rapidly and long-lasting with the reduction of levothyroxine dosage. No bone-active treatment was warranted. INTRODUCTION: Hyperthyroidism is a known risk factor for osteoporosis and fractures. Recent studies on patients with serum thyrotropin-suppressive therapy have not, however, indicated adverse effects on bone during long-term follow-up...
March 21, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28260180/sleeve-gastrectomy-leads-to-easy-management-of-hormone-replacement-therapy-and-good-weight-loss-in-patients-treated-for-craniopharyngioma
#2
Manuela Trotta, Joël Da Broi, Angelo Salerno, Rosa M Testa, Giuseppe M Marinari
The aim of this study is to investigate the effects of sleeve gastrectomy on hormone replacement therapy and on hypothalamic obesity in patients affected by craniopharyngioma with post-surgical pan-hypopituitarism. A retrospective review of three patients, treated for hypothalamic obesity with laparoscopic sleeve gastrectomy, who have previously undergone surgery for craniopharyngioma in their childhood, was done. Patients' mean age and BMI were 22.3 years (range 21-24) and 49.2 kg/m(2) (range 41.6-58.1), respectively...
March 4, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28249134/treatment-of-subclinical-hypothyroidism-or-hypothyroxinemia-in-pregnancy
#3
RANDOMIZED CONTROLLED TRIAL
Brian M Casey, Elizabeth A Thom, Alan M Peaceman, Michael W Varner, Yoram Sorokin, Deborah G Hirtz, Uma M Reddy, Ronald J Wapner, John M Thorp, George Saade, Alan T N Tita, Dwight J Rouse, Baha Sibai, Jay D Iams, Brian M Mercer, Jorge Tolosa, Steve N Caritis, J Peter VanDorsten
Background Subclinical thyroid disease during pregnancy may be associated with adverse outcomes, including a lower-than-normal IQ in offspring. It is unknown whether levothyroxine treatment of women who are identified as having subclinical hypothyroidism or hypothyroxinemia during pregnancy improves cognitive function in their children. Methods We screened women with a singleton pregnancy before 20 weeks of gestation for subclinical hypothyroidism, defined as a thyrotropin level of 4.00 mU or more per liter and a normal free thyroxine (T4) level (0...
March 2, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28225316/adverse-event-reporting-in-patients-treated-with-thyroid-hormone-extract
#4
Rupendra T Shrestha, Alan Malabanan, Bryan R Haugen, Elliott G Levy, James V Hennessey
OBJECTIVE: Thyroid hormone extract is used for the treatment of thyroid disorders but limited data exist on adverse events commonly noted by the physicians associated with this use. The purpose of this survey was to report adverse events observed by expert physicians managing patients treated for thyroid disease with thyroid hormones. METHODS: Members of the American Thyroid Association, The Endocrine Society and the American Association of Clinical Endocrinologists developed a survey instrument modeled on the FDA's reported adverse events for levothyroxine that would effectively assess the clinical experience of frequent prescribers of thyroid hormone...
February 22, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28217518/a-2016-clinical-practice-pattern-in-the-management-of-primary-hypothyroidism-among-doctors-from-different-clinical-specialties-in-new-delhi
#5
Vineet Surana, Sameer Aggarwal, Deepak Khandelwal, Rajiv Singla, Saptarshi Bhattacharya, Sachin Chittawar, Sanjay Kalra, Deep Dutta
BACKGROUND: This study aimed to document practices in managing hypothyroidism among doctors in New Delhi, with special focus on subclinical hypothyroidism, pregnancy, and old age, and to compare it with global practices. METHODS: During an academic program attended by 394 doctors, all participants were given a questionnaire designed based on thyroid practices survey done by Burch et al. to evaluate the practice patterns. Questions were based on evaluating doctor's preferred choices in diagnosis, therapy, and follow-up of hypothyroidism in different scenarios...
January 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28208903/nephrotic-syndrome-increases-the-need-for-levothyroxine-replacement-in-patients-with-hypothyroidism
#6
Hareeshababu Karethimmaiah, Vijaya Sarathi
INTRODUCTION: Nephrotic syndrome is a known cause of hypothyroidism; however, its effect on replacement doses of L-thyroxine in patients with primary hypothyroidism is not systematically studied. AIM: The aim of the present study was to evaluate the effect of newly diagnosed nephrotic syndrome on the dose of L-thyroxine replacement in previously diagnosed patients with primary hypothyroidism who were on full, stable dose of L-thyroxine replacement for at least one year...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28207545/primary-hypothyroidism-in-the-community-lower-daily-dosages-of-levothyroxine-replacement-therapy-for-asian-patients
#7
Ngiap Chuan Tan, Rong Quan Chew, Yi Ling Eileen Koh, Reena Chandini Subramanian, Usha Sankari, Meykkumar Meyappan, Li Wei Cho
The goal of treatment in patients with primary hypothyroidism is to attain euthyroidism guided by the stipulated thyroid-stimulating hormone (TSH) levels range so as to minimize any potential long-term adverse effects. However, various factors may result in their Levothyroxine (T4) under and over-replacement.Our study aimed to evaluate the mean daily dose of L-T4 replacement for Asian patients with primary hypothyroidism. The secondary aims were to determine the proportion of those who were either over or under-replaced, and the factors associated with their thyroid function status and replacement adherence...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28204953/pharmacokinetics-of-coadministration-of-levothyroxine-sodium-and-alendronate-sodium-new-effervescent-formulation
#8
H G Bone, M A Walter, M E Hurley, S Epstein
No clinically important pharmacokinetic interference of alendronate occurred between a new effervescent formulation of alendronate and levothyroxine when coadministered. The combination does not materially affect levothyroxine absorption. INTRODUCTION: Concurrent treatment of osteoporosis with alendronate (Aln) and hypothyroidism with levothyroxine (LT4) may be problematic because both drugs are to be taken separately after fasting overnight. The primary objective was to assess pharmacokinetic interactions between a new effervescent formulation of Aln (Aln-NEF) and LT4...
February 16, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28179450/prevalence-incidence-and-associated-comorbidities-of-treated-hypothyroidism-an-update-from-a-european-population
#9
Carlo B Giorda, Paolo Carnà, Francesco Romeo, Giuseppe Costa, Barbara Tartaglino, Roberto Gnavi
OBJECTIVE: Estimates of the prevalence of hypothyroidism in unselected populations date from the late 1990s. We present an update on the prevalence and incidence of overt hypothyroidism in Piedmont, northwest Italy and examine the association between hypothyroidism and multiple chronic comorbidities. DESIGN AND METHODS: Data were obtained from drug prescription and hospital discharge databases. Individuals who had received at least two levothyroxine prescriptions in 2012 were defined as having hypothyroidism; those who had undergone thyroidectomy or I(131) irradiation in the previous 5 years were defined as having iatrogenic hypothyroidism and those who had either obtained exemption from treatment co-payment or had been discharged from hospital with a chronic comorbidity (diabetes and connective tissue diseases) were identified as having one of these conditions...
May 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28167509/results-from-a-phase-i-ii-open-label-dose-finding-study-of-pralatrexate-and-oral-bexarotene-in-patients-with-relapsed-refractory-cutaneous-t-cell-lymphoma
#10
Madeleine Duvic, Youn H Kim, Pier Luigi Zinzani, Steven Horwitz
PURPOSE: Pralatrexate is a folic acid analog metabolic inhibitor similar to methotrexate,that has shown tolerability and efficacy with an overall response rate of 45% in a phase 1 dose de-escalation study of patients with relapsed/refractory cutaneous T-cell lymphoma CTCL. EXPERIMENTAL DESIGN: The object of this phase I/II open-label, multi-center clinical trial was to determine the maximum tolerated dose (MTD) and recommended dose of pralatrexate plus oral bexarotene in 34 patients with relapsed/refractory CTCL who had failed prior systemic therapies...
February 6, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28158982/study-protocol-thyroid-hormone-replacement-for-untreated-older-adults-with-subclinical-hypothyroidism-a-randomised-placebo-controlled-trial-trust
#11
RANDOMIZED CONTROLLED TRIAL
David J Stott, Jacobijn Gussekloo, Patricia M Kearney, Nicolas Rodondi, Rudi G J Westendorp, Simon Mooijaart, Sharon Kean, Terence J Quinn, Naveed Sattar, Kirsty Hendry, Robert Du Puy, Wendy P J Den Elzen, Rosalinde K E Poortvliet, Jan W A Smit, J Wouter Jukema, Olaf M Dekkers, Manuel Blum, Tinh-Hai Collet, Vera McCarthy, Caroline Hurley, Stephen Byrne, John Browne, Torquil Watt, Douglas Bauer, Ian Ford
BACKGROUND: Subclinical hypothyroidism (SCH) is a common condition in elderly people, defined as elevated serum thyroid-stimulating hormone (TSH) with normal circulating free thyroxine (fT4). Evidence is lacking about the effect of thyroid hormone treatment. We describe the protocol of a large randomised controlled trial (RCT) of Levothyroxine treatment for SCH. METHODS: Participants are community-dwelling subjects aged ≥65 years with SCH, diagnosed by elevated TSH levels (≥4...
February 3, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/28155174/undertreated-hypothyroidism-due-to-calcium-or-iron-supplementation-corrected-by-oral-liquid-levothyroxine
#12
Salvatore Benvenga, Flavia Di Bari, Roberto Vita
PURPOSE: The aim of this study was to assess whether oral liquid levothyroxine would correct tablet levothyroxine malabsorption induced by calcium or iron, two sequestrants of levothyroxine. METHODS: Nineteen adult hypothyroid patients with tablet levothyroxine malabsorption caused by calcium and/or iron supplements were switched from tablet to liquid levothyroxine at the same dose. Primary outcomes were: (1) significantly lower mean serum thyroid-stimulating hormone with the liquid compared with the tablet formulation, and (2) significantly greater rate of serum thyroid-stimulating hormone less than or equal to 4...
February 3, 2017: Endocrine
https://www.readbyqxmd.com/read/28155170/treatment-pattern-and-frequency-of-serum-tsh-measurement-in-users-of-different-levothyroxine-formulations-a-population-based-study-during-the-years-2009-2015
#13
Rosarita Ferrara, Valentina Ientile, Vincenzo Arcoraci, Carmen Ferrajolo, Carlo Piccinni, Andrea Fontana, Salvatore Benvenga, Gianluca Trifirò
BACKGROUND: Several conditions can modify the intestinal absorption of levothyroxine tablets, with potential consequences on their therapeutic effect. Pre-dosed ampoules and oral drops have been recently made available to overcome this limitation. AIMS: To describe the pattern of use of different formulations of levothyroxine in a general population of Southern Italy and to perform an exploratory analysis investigating the effect of switching from levothyroxine tablets to oral liquid formulations...
February 2, 2017: Endocrine
https://www.readbyqxmd.com/read/28151692/oral-liquid-levothyroxine-solves-the-problem-of-tablet-levothyroxine-malabsorption-due-to-concomitant-intake-of-multiple-drugs
#14
Roberto Vita, Flavia Di Bari, Salvatore Benvenga
BACKGROUND: Unlike the tablet (TAB) formulation, liquid L-T4 (LIQ) is directly absorbed in the intestine. The aim of this study was to assess whether LIQ was superior to TAB, such that it would overcome the interference induced by co-ingestion of multiple interfering drugs (ID). METHODS: In this prospective cohort study, we recruited 11 patients with apparent reduced TAB absorption due to ≥ 2 ID, and switched them to LIQ while maintaining the daily dose and the co-ingestion of the ID...
February 13, 2017: Expert Opinion on Drug Delivery
https://www.readbyqxmd.com/read/28125093/effect-of-l-thyroxine-supplementation-on-very-low-birth-weight-infants-with-transient-hypothyroxinemia-of-prematurity-at-3-years-of-age
#15
A Uchiyama, R Kushima, T Watanabe, S Kusuda
OBJECTIVE: To evaluate the effects of levothyroxine (L-T4) supplementation on growth and neurodevelopmental outcomes at 3 years of age in very low birth weight (VLBW) infants with transient hypothyroxinemia of prematurity (THOP). STUDY DESIGN: VLBW infants with plasma thyroid-stimulating hormone concentrations <10 mIU l(-1) and free thyroxine concentrations <0.8 ng dl(-1) were defined as having THOP and randomly assigned to the Treated (20 infants) or Untreated (31 infants) group...
January 26, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28100579/acute-mania-after-levothyroxine-replacement-for-hypothyroid-induced-heart-block
#16
Marc Gregory Yu, Karen Marie Flores, Iris Thiele Isip-Tan
Psychiatric disturbances can manifest after levothyroxine (LT4) treatment for severe hypothyroidism. We present the case of a young Filipino man with Hashimoto's thyroiditis and high-grade heart block, who was given a full replacement LT4 dose on admission. Twenty-four hours after this dose, he developed manic symptoms, which were addressed with sedatives and neuroleptics with gradual restoration of euthymia the following day. A comprehensive workup did not reveal any findings suggestive of another aetiology for either mania or heart block...
January 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28081173/effect-of-rifampin-on-thyroid-function-test-in-patients-on-levothyroxine-medication
#17
Hye In Kim, Tae Hyuk Kim, Hosu Kim, Young Nam Kim, Hye Won Jang, Jae Hoon Chung, Seong Mi Moon, Byung Woo Jhun, Hyun Lee, Won-Jung Koh, Sun Wook Kim
BACKGROUND: Levothyroxine (LT4) and rifampin (RIF) are sometimes used together; however, no clinical studies have assessed the effects of these drugs on thyroid function or the need to adjust LT4 dose. METHODS: We retrospectively reviewed the records of 71 Korean patients who started RIF during LT4 treatment. Clinically relevant cases that required dose adjustment according to the American Thyroid Association (ATA)/American Association of Clinical Endocrinologists (AACE) guidelines were identified, and risk factors of increased LT4 dose were analyzed...
2017: PloS One
https://www.readbyqxmd.com/read/28055088/myxedema-psychosis-in-a-patient-with-undiagnosed-hashimoto-thyroiditis
#18
Matthew M Mavroson, Nirav Patel, Eleonora Akker
Myxedema psychosis is uncommon in patients with primary hypothyroidism. Most often, this disease state can be found in patients with Hashimoto thyroiditis or after total thyroidectomy. Chronic hypothyroidism can lead to an insidious onset of psychiatric symptoms in patients, such as dementia, delirium, psychosis, hallucinations, and coma. A 31-year-old man with an unremarkable medical history was brought to the psychiatric emergency department for new-onset aggression, paranoid behavior, and hallucinations for 4 days...
January 1, 2017: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/27982198/treatment-of-hypothyroidism-with-levothyroxine-plus-liothyronine-a-randomized-double-blind-crossover-study
#19
Juliana Kaminski, Fabíola Yukiko Miasaki, Gilberto Paz-Filho, Hans Graf, Gisah Amaral de Carvalho
Objective: To compare the effects of a unique fixed combination levothyroxine/liothyronine (LT4/LT3) therapy in patients with primary hypothyroidism. Subjects and methods: This is a randomized, double-blind, crossover study. Adults with primary hypothyroidism (n = 32, age 42.6 ± 13.3, 30 females) on stable doses of LT4 for ≥ 6 months (125 or 150 μg/day) were randomized to continue LT4 treatment (G1) or to start LT4/LT3 therapy (75/15 μg/day; G2). After 8 weeks, participants switched treatments for 8 more weeks...
November 2016: Archives of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27943146/retrospective-study-of-patients-switched-from-tablet-formulations-to-a-gel-cap-formulation-of-levothyroxine-results-of-the-control-switch-study
#20
Frank R Ernst, Walter Sandulli, Riad Elmor, Jennifer Welstead, Arnold B Sterman, MaryKate Lavan
INTRODUCTION: Medication changes involving levothyroxine-either dose titrations or switching formulations-occur frequently in patients with erratic thyroid-stimulating hormone (TSH) levels and persistent hypothyroid symptoms. We investigated whether switching patients from levothyroxine tablets to a gel cap formulation of levothyroxine might reduce dose adjustments and improve tolerability and efficacy outcomes. OBJECTIVES: Primary study objectives included quantifying the percentage of patients achieving TSH levels within a pre-specified range, median dose changes experienced, and the percentage of patients with improved hypothyroid symptom control after switching from levothyroxine tablets to levothyroxine gel caps...
March 2017: Drugs in R&D
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