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https://www.readbyqxmd.com/read/29778126/is-parenteral-levothyroxine-therapy-safe-in-intractable-hypothyroidism
#1
Hande Peynirci, Bengur Taskiran, Erdinc Erturk, Pınar Sisman, Canan Ersoy
CASE: A 32-year old woman was admitted to the hospital due to intractable hypothyroidism refractory to high dose of oral l-thyroxine therapy. She underwent total thyroidectomy and radioactive iodine therapy due to papillary thyroid cancer. After excluding poor adherence to therapy and malabsorption, levothyroxine absorption test was performed. No response was detected. Transient neurologic symptoms developed during the test. She developed 3 attacks consisting of neurologic symptoms during high dose administration...
June 2018: Journal of the National Medical Association
https://www.readbyqxmd.com/read/29757661/a-pivotal-field-study-to-support-the-registration-of-levothyroxine-sodium-tablets-for-canine-hypothyroidism
#2
Victoria A Lewis, Carla M K Morrow, Johnny A Jacobsen, W Eugene Lloyd
A prospective, pivotal, multicenter field study to evaluate the dose regimen, effectiveness, and safety of levothyroxine sodium tablets, USP for the treatment of hypothyroidism and hypothyroidism-associated clinical signs in dogs was conducted. Ninety-two dogs diagnosed with primary hypothyroidism met the entrance criteria and were enrolled into the study. Levothyroxine sodium was administered to each dog on a daily basis either as the whole dose q 24 hr or as half the dose q 12 hr. Dosing started at 0.1 mg/10 lb (0...
May 14, 2018: Journal of the American Animal Hospital Association
https://www.readbyqxmd.com/read/29735582/thyroid-hormones-are-transport-substrates-and-transcriptional-regulators-of-organic-anion-transporting-polypeptide-2b1
#3
Henriette E Meyer Zu Schwabedissen, Celio Ferreira, Anima M Schaefer, Mouhssin Oufir, Isabell Seibert, Matthias Hamburger, Rommel G Tirona
Levothyroxine replacement therapy forms the cornerstone of hypothyroidism management. Variability in levothyroxine oral absorption may contribute to the well-recognized large interpatient differences in required dose. Moreover, levothyroxine-drug pharmacokinetic interactions are thought to be caused by altered oral bioavailability. Interestingly, little is known regarding the mechanisms contributing to levothyroxine absorption in the gastrointestinal tract. Here, we aimed to determine whether the intestinal drug uptake transporter Organic Anion Transporting Polypeptide 2B1 (OATP2B1) may be involved in facilitating intestinal absorption of thyroid hormones...
May 7, 2018: Molecular Pharmacology
https://www.readbyqxmd.com/read/29722287/effects-of-enteral-different-dose-levothyroxine-sodium-pretreatment-on-serum-thyroid-hormone-levels-and-myocardial-ischemia-reperfusion-injury
#4
Gui-Zhen Yang, Fu-Shan Xue, Ya-Yang Liu, Hui-Xian Li, Qing Liu, Xu Liao
INTRODUCTION: The available evidence shows that perioperative oral thyroid hormone can significantly attenuate the postoperative decline in the serum hormone level and improve postoperative hemodynamic and prognostic parameters. However, there has been no study assessing the effects of preoperative oral different-dose thyroid hormone on serum hormone levels and myocardial ischemia-reperfusion injury (IRI) after cardiac surgery. METHODS: Forty-eight healthy Wistar rats, aged 35 days, were randomly allocated into six groups: Group BC, Group C and four pretreatment groups in which the rats were given levothyroxine-sodium of 10 μg, 20 μg, 40 μg and 80 μg/100 g...
April 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29720960/increased-requirement-of-replacement-doses-of-levothyroxine-caused-by-liver-cirrhosis
#5
Salvatore Benvenga, Giovanni Capodicasa, Sarah Perelli, Silvia Martina Ferrari, Poupak Fallahi, Alessandro Antonelli
Background: Since hypothyroidism is a fairly common dysfunction, levothyroxine (L-T4) is one of the most prescribed medications. Approximately 70% of the administered L-T4 dose is absorbed. The absorption process takes place in the small intestine. Some disorders of the digestive system and some medicines, supplements, and drinks cause L-T4 malabsorption, resulting in failure of serum TSH to be normal. Only rarely liver cirrhosis is mentioned as causing L-T4 malabsorption. Case report: In this study, we report increased requirement of daily doses of l-thyroxine in two patients with the atrophic variant of Hashimoto's thyroiditis and liver cirrhosis...
2018: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/29718334/low-dose-levothyroxine-reduces-intrahepatic-lipid-content-in-patients-with-type-2-diabetes-mellitus-and-nafld
#6
Eveline Bruinstroop, Rinkoo Dalan, Cao Yang, Yong Mong Bee, Kurumbian Chandran, Li Wei Cho, Shui Boon Soh, Eng Kiong Teo, Sue-Anne Toh, Melvin Khee Shing Leow, Rohit A Sinha, Suresh Anand Sadananthan, Navin Michael, Heather Stapleton, Christopher Leung, Peter W Angus, Sheila K Patel, Louise M Burrell, Lim Su Chi, Sum Chee Fang, S Sendhil Velan, Paul M Yen
Context/Objective: Non-alcoholic fatty liver disease (NAFLD) is highly prevalent in patients with type 2 diabetes mellitus and associated with significant morbidity and mortality. Thyroid hormone (TH) increases β-oxidation of fatty acids and decreases intrahepatic lipid content (IHLC) in rodents with NAFLD. In this study we investigated the possibility of low intrahepatic TH concentration in NAFLD and studied the effect of TH treatment in humans. Design/Setting: We performed a phase 2b single arm study in six hospitals in Singapore to study whether TH reduced IHLC...
April 27, 2018: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29715192/does-initial-dosing-of-levothyroxine-in-infants-with-congenital-hypothyroidism-lead-to-frequent-dose-adjustments-secondary-to-iatrogenic-hyperthyroidism-on-follow-up
#7
Meghan Craven, Graeme R Frank
BACKGROUND: Congenital hypothyroidism (CH) is the most common preventable cause of intellectual disability. The recommended starting dose of levothyroxine (LT4) is between 10 and 15 μg/kg, an extremely wide range. We hypothesized that a sizable proportion of newborns treated for CH at the higher end of the dosage range become biochemically hyperthyroid at a follow-up visit. METHODS: This study is a retrospective chart review of infants with CH between 2002 and 2012...
May 1, 2018: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/29706030/preconception-management-of-thyroid-dysfunction
#8
Onyebuchi E Okosieme, Ishrat Khan, Peter N Taylor
Uncorrected thyroid dysfunction in pregnancy has well recognised deleterious effects on fetal and maternal health. The early gestation period is one of critical fetal vulnerability during which maternal thyroid dysfunction may have lasting repercussions. Accordingly, a pragmatic preconception strategy is key for ensuring optimal thyroid disease outcomes in pregnancy. Preconception planning in women with hypothyroidism should pre-empt and mirror the adaptive changes of the thyroid gland by careful levothyroxine dose adjustments to ensure adequate fetal thyroid hormone delivery in pregnancy...
April 29, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29701867/pregnancy-complications-associated-with-maternal-hypothyroidism-a-systematic-review
#9
Danielle Rosani Shinohara, Thais da Silva Santos, Hayalla Corrêa de Carvalho, Laíza Cristina Bahls Lopes, Luciene Setsuko Akimoto Günther, Sandra Mara Alessi Aristides, Jorge Juarez Vieira Teixeira, Izabel Galhardo Demarchi
Importance: Hypothyroidism is one of the most prevalent diseases in pregnancy, but there is no consensus about its management in pregnant women. Objective: In this systematic review, we evaluated the association between pregnancy complications and treated or untreated maternal hypothyroidism. Evidence Acquisition: PubMed and reference lists were searched for the Medical Subject Headings terms "pregnancy complications" and "hypothyroidism...
April 2018: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/29619010/thyroxine-treatment-with-softgel-capsule-formulation-usefulness-in-hypothyroid-patients-without-malabsorption
#10
Pierpaolo Trimboli, Camilla Virili, Marco Centanni, Luca Giovanella
Background: Levothyroxine sodium (LT4) is the therapy of choice for hypothyroidism. In the last decade, new LT4 formulations, such as liquid and softgel capsules, became available. Even if some evidence has been reached in the efficacy of liquid LT4 in patients with suboptimal TSH on tablet LT4, the usefulness of softgel LT4 has been rarely studied. This study aimed at evaluating the effect of switching from tablet to softgel LT4 patients without increased need for LT4. TSH was used as proxy of LT4 bioavailability and effectiveness...
2018: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/29582344/tsh-evaluation-in-hypothyroid-patients-assuming-liquid-levothyroxine-at-breakfast-or-30-min-before-breakfast
#11
I Pirola, E Gandossi, D Brancato, F Marini, A Cristiano, A Delbarba, B Agosti, M Castellano, C Cappelli
PURPOSE: To compare TSH levels of hypothyroid patients treated with liquid LT4 at breakfast or 30 min before breakfast. PATIENTS AND METHODS: Subjects, aged 18-75 years old, were eligible if they presented hypothyroidism, due to Hashimoto's thyroiditis or after thyroidectomy for proven benign goiter. Seven hundred ninety-eight patients were recruited and enrolled in the study. Thirty-seven subjects withdrew from the trial. A total of 761 patients (mean age 46...
March 26, 2018: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/29541433/effects-of-levothyroxine-on-visual-evoked-potential-impairment-following-local-injections-of-lysolecithin-into-the-rat-optic-chiasm
#12
Cobra Payghani, Fatemeh Khani, Aryan Rafieezadeh, Parham Reisi, Hojjatallah Alaei, Bahman Rashidi
Background: Multiple sclerosis (MS) is a demyelinating disease of the central nervous system which has no any known definitive treatment. Studies have shown that thyroid hormones (THs) in addition to their roles in the development of the nervous system and the production of myelin have important roles in the adult's brain function. Since the only way to treat MS is the restoration of myelin, the aim of this study was to evaluate the effects of levothyroxine on visual evoked potential (VEP) impairment following local injections of lysolecithin into the rat optic chiasm...
2018: International Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29530271/decreased-sensitivity-of-thyrotropin-thyroid-hormone-feedback-control-in-hypothyroid-and-athyreotic-patients-treated-with-levothyroxine-is-serum-triiodothyronine-involved
#13
Darko Solter, Miljenko Solter
OBJECTIVES: The search for optimal therapy for hypothyroidism is challenging and complex and is still going on. We investigated TSH-thyroid hormone feedback control in hypothyroid and athyreotic patients properly treated with levothyroxine (LT4), based on normal TSH values. MATERIAL AND METHODS: We randomly selected 150 hypothyroid, 110 athyreotic and 210 euthyroid subjects, determined their serum T4, T3 and TSH values and calculated T4/TSH and T3/T4 ratios. RESULTS: The TSH distribution in hypothyroidism was significantly shifted to the higher and that in athyreosis to the lower values from the normal distribution in euthyroid controls...
April 2018: Annales D'endocrinologie
https://www.readbyqxmd.com/read/29509918/effects-of-altering-levothyroxine-l-t4-doses-on-quality-of-life-mood-and-cognition-in-l-t4-treated-subjects
#14
Mary H Samuels, Irina Kolobova, Meike Niederhausen, Jeri S Janowsky, Kathryn G Schuff
Background: The brain is a critical target organ for thyroid hormone, but it is unclear whether variations in thyroid function within and near the reference range affect quality of life, mood, or cognition. Methods: A total of 138 subjects with levothyroxine (L-T4)-treated hypothyroidism and normal thyrotropin (TSH) levels underwent measures of quality of life (36-Item Short Form Health Survey, Underactive Thyroid-Dependent Quality of Life Questionnaire), mood (Profile of Mood States, Affective Lability Scale), and cognition (executive function, memory)...
May 1, 2018: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29497539/treatment-of-congenital-hypothyroidism-in-a-newborn-with-malabsorption-after-subtotal-ileum-resection
#15
Charlotte S Schömig, Marie-Ève Robinson, Julia E von Oettingen
Congenital hypothyroidism requires prompt treatment to prevent adverse health outcomes. Poor intestinal levothyroxine absorption can complicate management. We present a case of a term female newborn with necrotizing enterocolitis (NEC) requiring subtotal ileum resection. Congenital hypothyroidism was diagnosed by newborn screening. Treatment was complicated by intestinal malabsorption of levothyroxine. Intravenous levothyroxine substitution restored euthyroidism and supraphysiologic PO doses subsequently maintained a euthyroid state...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29490937/management-of-endocrine-disease-pitfalls-on-the-replacement-therapy-for-primary-and-central-hypothyroidism-in-adults
#16
REVIEW
Gisah Amaral de Carvalho, Gilberto Paz-Filho, Cleo Mesa Junior, Hans Graf
Hypothyroidism is one of the most common hormone deficiencies in adults. Most of the cases, particularly those of overt hypothyroidism, are easily diagnosed and managed, with excellent outcomes if treated adequately. However, minor alterations of thyroid function determine nonspecific manifestations. Primary hypothyroidism due to chronic autoimmune thyroiditis is largely the most common cause of thyroid hormone deficiency. Central hypothyroidism is a rare and heterogeneous disorder characterized by decreased thyroid hormone secretion by an otherwise normal thyroid gland, due to lack of TSH...
June 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29467136/attitudes-and-perceptions-of-health-professionals-towards-management-of-hypothyroidism-in-general-practice-a-qualitative-interview-study
#17
Rosie Dew, Kathryn King, Onyebuchi E Okosieme, Simon H Pearce, Gemma Donovan, Peter N Taylor, Janis Hickey, Colin M Dayan, Graham Leese, Salman Razvi, Scott Wilkes
OBJECTIVE: To explore the attitudes and perceptions of health professionals towards management of hypothyroidism that contributes to the suboptimal treatment of hypothyroidism in general practice. DESIGN: A qualitative interview study using semistructured interviews. PARTICIPANTS: Sixteen participants were interviewed between March and August 2016 comprising nine general practitioners (GPs), four pharmacists, two practice nurses and one nurse practitioner...
February 21, 2018: BMJ Open
https://www.readbyqxmd.com/read/29447437/j-shaped-association-between-postoperative-levothyroxine-dosage-and-fracture-risk-in-thyroid-cancer-patients-a-retrospective-cohort-study
#18
Dong Wook Shin, Beomseok Suh, Hyunsun Lim, Jae Moon Yun, Sun Ok Song, Youngmin Park
Long-term administration of supraphysiologic dosages of levothyroxine can have detrimental effect on the bone. We aimed to investigate fracture incidence among post-thyroidectomy thyroid cancer patients compared with a matched comparison group, and explore the association between levothyroxine dosage and fracture risk. From the Korean National Health Insurance database, virtually all thyroid cancer patients who received thyroidectomy in Korea from January 1, 2004 to December 31, 2012 were included. Matched subjects were selected by 1:1 propensity score matching...
February 15, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/29445919/appraisal-of-clinical-practice-guidelines-on-the-management-of-hypothyroidism-in-pregnancy-using-the-appraisal-of-guidelines-for-research-and-evaluation-ii-instrument
#19
REVIEW
Yuan Fang, Liang Yao, Jing Sun, Jian Zhang, Yanxia Li, Ruifei Yang, Kehu Yang, Limin Tian
PURPOSE: This study aimed to systematically evaluate the quality of guidelines for the management of hypothyroidism in pregnancy. METHOD: Systematic searches were conducted to identify hypothyroidism in pregnancy guidelines published in electronic databases and developers' websites. Four reviewers independently evaluated eligible guidelines using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. Agreement among reviewers was measured using the intraclass correlation coefficient (ICC)...
April 2018: Endocrine
https://www.readbyqxmd.com/read/29434573/levothyroxine-therapy-changes-of-tsh-levels-by-switching-patients-from-tablet-to-liquid-formulation-a-systematic-review-and-meta-analysis
#20
Camilla Virili, Luca Giovanella, Poupak Fallahi, Alessandro Antonelli, Maria Giulia Santaguida, Marco Centanni, Pierpaolo Trimboli
Background: In the last years, levothyroxine (LT4) has been commercialized also in liquid formulation, which is less sensitive to the factors known to reduce the absorption of tablet LT4. To date, there is no robust information that liquid LT4 can improve pharmacologic thyroid homeostasis of patients with reduced efficacy of tablet LT4. This analysis aimed at achieving solid evidence that switching thyroxine treatment from tablet to liquid preparation improves patients' TSH levels. Methods: The search was performed in PubMed/MEDLINE and Scopus database based on the terms "thyroid," "levothyroxine," and "liquid," and updated until September 25, 2017...
2018: Frontiers in Endocrinology
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