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https://www.readbyqxmd.com/read/28100579/acute-mania-after-levothyroxine-replacement-for-hypothyroid-induced-heart-block
#1
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
#2
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
#3
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
#4
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
#5
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...
December 9, 2016: Drugs in R&D
https://www.readbyqxmd.com/read/27942261/congenital-hypothyroidism-optimal-initial-dosage-and-time-of-initiation-of-treatment-a-systematic-review
#6
REVIEW
Khaled Rahmani, Shahin Yarahmadi, Koorosh Etemad, Ahmad Koosha, Yadollah Mehrabi, Nasrin Aghang, Hamid Soori
CONTEXT: Appropriate management of neonates, tested positive for congenital hypothyroidism (CH), in particular, the initial dosage of levothyroxine and the time of initiation of treatment is a critical issue. The aim of this study was to assess all current evidence available on the subject to ascertain the optimal initial dose and optimal initiation time of treatment for children with CH. EVIDENCE ACQUISITION: In this study, all published research related to the initiation treatment dose and the onset time of treatment in congenital hypothyroidism were reviewed...
July 2016: International Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27809623/onset-of-graves-disease-during-pregnancy-in-a-woman-with-established-hypothyroidism
#7
María Alberiche, Rosa María Sánchez-Hernández, Xabier López Mérida, Ana María Wägner
BACKGROUND: Pregnancy strongly influences the thyroid gland and its function. Thyroid guidelines recommend a 30 to 50% increase of the preconceptional levothyroxine dose in women with hypothyroidism, when pregnancy is diagnosed. CASE: A 33 year-old, 8-week pregnant woman with hypothyroidism, presents with a 2-week history of palpitations, sweating, nervousness and fatigue. Physical examination shows tachycardia (108 bpm), distal tremors and diffuse goiter. After biochemical confirmation of hyperthyroidism, her levothyroxine dose is reduced and finally interrupted...
November 4, 2016: Gynecological Endocrinology
https://www.readbyqxmd.com/read/27798756/the-economic-impact-of-levothyroxine-dose-adjustments-the-control-he-study
#8
Frank R Ernst, Peri Barr, Riad Elmor, Walter Sandulli, Lionel Thevathasan, Arnold B Sterman, Jessica Goldenberg, Kevin Vora
BACKGROUND: In general, hypothyroidism can be adequately treated with a consistent daily dose of levothyroxine. However, the need for levothyroxine dose adjustments is frequent in clinical practice. The extent to which levothyroxine dose adjustments increase the utilization of healthcare resources has not previously been described in the clinical literature. OBJECTIVE: The primary objective of our study was to measure the effect of levothyroxine dose adjustments in terms of their utilization of healthcare resources including direct and indirect costs...
January 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/27793241/seizure-due-to-multiple-drugs-intoxication-a-case-report
#9
Handan Gulec, Munire Babayigit, Aysun Kurtay, Mehmet Sahap, Fatma Ulus, Zehra Tutal, Eyup Horasanli
The mechanism of the antidepressant effect of bupropion is not fully understood. Besides, using it in the treatment of depression, it is found to be effective in reducing withdrawal symptoms due to smoking cessation. A 28-year-old female patient with a history of depression was admitted to emergency department an hour after ingestion of bupropion, quetiapine, and levothyroxine in high doses to commit suicide. While accepting her into the Intensive Care Unit, she was awake, alert, disoriented and agitated. After 2h, the patient had a generalized tonic-clonic seizure...
November 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27785940/therapeutic-effects-of-blue-honeysuckle-on-lesions-of-hyperthyroidism-in-rats
#10
Sang-In Park, Young Joon Lee, Seong Hun Choi, Soo Jin Park, Chang-Hyun Song, Sae-Kwang Ku
Hyperthyroidism is a hypermetabolic syndrome characterized by an overproduction of thyroid hormones, which enhances the hormone-induced oxidative stress responsible for some complications in the liver, heart and muscle. Blue honeysuckle (BH) is an edible berry, rich in polyphenols, especially flavonoids or anthocyanins, known as strong antioxidants. The chemo-protective activities of the berry have been connected to the improvement of symptoms in cancer, diabetes mellitus, tumor or cardiovascular diseases. Therefore, the therapeutic effects of BH were examined in hyperthyroidism rat model...
2016: American Journal of Chinese Medicine
https://www.readbyqxmd.com/read/27779557/variable-linezolid-exposure-in-icu-patients-possible-role-of-drug-drug-interactions
#11
Christoph Töpper, Cathérine Louise Steinbach, Christoph Dorn, Alexander Kratzer, Sebastian G Wicha, Michael Schleibinger, Uwe Liebchen, Frieder Kees, Bernd Salzberger, Martin G Kees
BACKGROUND: Standard doses of linezolid may not be suitable for all patient groups. ICU patients in particular may be at risk of inadequate concentrations. This study investigated variability of drug exposure and its potential sources in this population. PATIENTS AND METHODS: Plasma concentrations of linezolid were determined by HPLC in a convenience sample of 20 ICU patients treated with intravenous linezolid 600 mg twice daily. Ultrafiltration applying physiological conditions (pH 7...
October 24, 2016: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/27774323/syndrome-of-reduced-sensitivity-to-thyroid-hormones-two-case-reports-and-a-literature-review
#12
Anastasios Anyfantakis, Dimitrios Anyfantakis, Irene Vourliotaki
Resistance to thyroid hormone (RTH) is an extremely rare dominantly inherited condition of impaired tissue responsiveness to thyroid hormone (TH). Most patients with RTH have mutations in the gene that encodes the β isoform of the receptor of thyroid hormone (THR-β gene). Mutant receptors are unable to activate or repress target genes. The majority of them are asymptomatic or rarely have hypo- or hyperthyroidism. RTH is suspected by the finding of persistent elevation of serum levels of free T3 (FT3) and free T4 (FT4) and nonsuppressed TSH...
2016: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/27766119/study-of-optimal-replacement-of-thyroxine-in-the-elderly-sorted-results-from-the-feasibility-randomised-controlled-trial
#13
Salman Razvi, Lorna Ingoe, Vicky Ryan, Simon H S Pearce, Scott Wilkes
BACKGROUND: Hypothyroidism is a common condition, particularly in the older population. Thyroid hormone requirements change with age and serum TSH levels also alter, especially in older patients. However, in practice laboratory reference ranges for thyroid function are not age-specific and treatment in older patients aims to achieve a similar target thyroid function level as younger age groups. METHODS: A dual centre, single blind, randomised controlled trial was conducted to determine the feasibility of a future definitive RCT in hypothyroid individuals aged 80 years or older who were treated with levothyroxine...
2016: Thyroid Research
https://www.readbyqxmd.com/read/27759634/delayed-diagnosis-with-autoimmune-polyglandular-syndrome-type-2-causing-acute-adrenal-crisis-a-case-report
#14
Xiaojing Wang, Fan Ping, Cuijuan Qi, Xinhua Xiao
BACKGROUND: Autoimmune polyglandular syndrome type 2 (APS-2), also known as Schmidt's syndrome, is an uncommon disorder characterized by the coexistence of Addison's disease with thyroid autoimmune disease and/or type 1 diabetes mellitus. Addison's disease as the obligatory component is potentially life-threatening. Unfortunately, the delayed diagnosis of Addison's disease is common owing to its rarity and the nonspecific clinical manifestation. METHODS: Here we reported a case of 38-year-old female patient who presented with 2 years' history of Hashimoto's thyroiditis and received levothyroxine replacement...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27749579/drug-drug-interactions-with-imatinib-an-observational-study
#15
Isabelle Récoché, Vanessa Rousseau, Robert Bourrel, Maryse Lapeyre-Mestre, Leila Chebane, Fabien Despas, Jean-Louis Montastruc, Emmanuelle Bondon-Guitton
Many patients treated with imatinib, used in cancer treatment, are using several other drugs that could interact with imatinib. Our aim was to study all the drug-drug interactions (DDIs) observed in patients treated with imatinib.We performed 2 observational studies, between the 1st January 2012 and the 31st August 2015 in the Midi-Pyrénées area (South Western France), using the French health insurance reimbursement database and then the French Pharmacovigilance Database (FPVD).A total of 544 patients received at least 1 reimbursement for imatinib...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27741547/overview-of-hypothyroidism-in-pregnancy
#16
Jeffrey M Kroopnick, Caroline S Kim
Overt hypothyroidism in pregnancy, defined as an elevated serum thyroid-stimulating hormone (TSH) and reduced serum free thyroxine or a TSH >10 mIU/L, is known to have adverse effects on pregnancy. Subclinical hypothyroidism is typically defined as an elevated TSH and normal FT4 levels. There remains much controversy on the benefit of starting levothyroxine for mothers diagnosed with subclinical hypothyroidism. Recent studies are redefining the normal range for TSH in pregnancy, and the data on whether treatment of subclinical hypothyroidism improves outcomes for the mother and fetus are unclear...
November 2016: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/27718637/new-levothyroxine-formulation-meeting-95-105-specification-over-the-whole-shelf-life-results-from-two-pharmacokinetic-trials
#17
Ulrike Gottwald-Hostalek, Wolfgang Uhl, Peter Wolna, George J Kahaly
OBJECTIVE: Small levothyroxine (L-T4) dose changes can lead to significant clinical effects. To ensure thyroid hormone levels are safely maintained, authorities are increasingly adopting stricter potency specifications for L-T4, the most stringent of these being 95-105% of the labeled dose over the whole shelf-life. Levothyroxine sodium (Euthyrox, Eutirox, Lévothyrox ) has been reformulated, and two studies performed, to ensure bioequivalence to the currently marketed formulation and dosage form proportionality of the new formulation...
February 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27700539/is-a-normal-tsh-synonymous-with-euthyroidism-in-levothyroxine-monotherapy
#18
Sarah J Peterson, Elizabeth A McAninch, Antonio C Bianco
CONTEXT: Levothyroxine (LT4) monotherapy is the standard of care for hypothyroidism. OBJECTIVE: To determine whether LT4 at doses that normalize the serum TSH is associated with normal markers of thyroid status. DESIGN: Cross-sectional data from the US National Health and Nutrition Examination Survey (2001-2012) was used to evaluate 52 clinical parameters. LT4 users were compared to healthy controls and controls matched for age, sex, race, and serum TSH...
December 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27633516/women-in-cancer-thematic-review-thyroid-stimulating-hormone-in-thyroid-cancer-does-it-matter
#19
REVIEW
Hannah Nieto, Kristien Boelaert
Differentiated thyroid cancer is the most common endocrine malignancy and the incidence is increasing rapidly worldwide. Appropriate diagnosis and post-treatment monitoring of patients with thyroid tumours are critical. Fine needle aspiration cytology remains the gold standard for diagnosing thyroid cancer, and although there have been significant refinements to this technique, diagnostic surgery is often required for patients suspected to have malignancy. Serum thyroid-stimulating hormone (TSH) is higher in patients with malignant thyroid nodules than in those with benign disease, and TSH is proportionally increased in more aggressive tumours...
November 2016: Endocrine-related Cancer
https://www.readbyqxmd.com/read/27631464/variable-linezolid-exposure-in-intensive-care-unit-patients-possible-role-of-drug-drug-interactions
#20
Christoph Töpper, Cathérine L Steinbach, Christoph Dorn, Alexander Kratzer, Sebastian G Wicha, Michael Schleibinger, Uwe Liebchen, Frieder Kees, Bernd Salzberger, Martin G Kees
BACKGROUND: Standard doses of linezolid may not be suitable for all patient groups. Intensive care unit (ICU) patients in particular may be at risk of inadequate concentrations. This study investigated variability of drug exposure and its potential sources in this population. METHODS: Plasma concentrations of linezolid were determined by high-performance liquid chromatography in a convenience sample of 20 ICU patients treated with intravenous linezolid 600 mg twice daily...
October 2016: Therapeutic Drug Monitoring
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