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JOURNAL ARTICLE
Jessica Hidalgo, Eddy P Lincango, Sandra Cordova-Madera, Kim Ruiz-Arellanos, Camila Wenczenovicz, Oscar Ponce, Neri Álvarez-Villalobos, Arbaaz Rao, Naykky M Singh Ospina, Spyridoula Maraka, Gonzalo J Acosta, Juan P Brito
BACKGROUND: Levothyroxine (LT4) monotherapy is the standard treatment for hypothyroidism; however, 10-15% of patients have persistent hypothyroid symptoms despite normalizing thyroid hormone levels with LT4. This study aims to summarize the best available evidence on interventions to improve symptomatology in patients with hypothyroidism and persistent symptoms. METHODS: A systematic search was conducted in March 2022 for randomized controlled trials and observational studies on interventions for adult patients with persistent hypothyroid symptoms despite biochemical euthyroidism on thyroid hormone replacement...
April 15, 2024: Endocrine
#2
Marissa Tucci, Robert Galagan, Dragana Lovre
The synthetic retinoid bexarotene (BXT), used in the treatment of cutaneous T-cell lymphoma (CTCL), has been associated with central hypothyroidism due to suppression of thyrotropin (TSH) secretion and upregulation of peripheral thyroxine (T4) and triiodothyronine (T3) metabolism. We present a case of a 41-year-old man with CTCL who developed central hypothyroidism within 1 month of receiving BXT. He required sequential uptitration of levothyroxine (LT4) over 15 months, and free T4 (FT4) and total T3 levels were normalized by a daily regimen of LT4 600 mcg and liothyronine (LT3) 15 mcg...
April 2024: JCEM Case Rep
#3
JOURNAL ARTICLE
Kamilla Ryom Riis, Camilla Bøgelund Larsen, Steen Joop Bonnema
BACKGROUND: Desiccated thyroid extract (DTE) is no longer recommended for treatment of hypothyroidism but is still in use. This review aimed to summarize the available literature on treatment with DTE in adult hypothyroid patients. METHODS: The search was conducted up until the 6th of January 2024 in six electronic databases. Two reviewers independently screened all search results. The retrieved studies compared DTE treatment with levothyroxine or combination therapy with liothyronine and levothyroxine...
March 25, 2024: Thyroid: Official Journal of the American Thyroid Association
#4
JOURNAL ARTICLE
Nicole Lafontaine, Suzanne J Brown, Petros Perros, Enrico Papini, Endre V Nagy, Roberto Attanasio, Laszlo Hegedüs, John P Walsh
OBJECTIVE: Hypothyroidism is a common endocrine condition usually managed with levothyroxine (LT4). However, controversy remains around the use of liothyronine (LT3). We aimed to investigate the practices of Australian endocrinologists when managing patients with hypothyroidism, their use of LT3 + LT4 combination therapy and use of thyroid hormones in euthyroid patients. DESIGN AND PARTICIPANTS: Members of the Endocrine Society of Australia (ESA) were invited to participate in an online questionnaire...
March 11, 2024: Clinical Endocrinology
#5
JOURNAL ARTICLE
Chaorong Yu, Yihan He, Qing Liu, Xiaoyun Qian, Xia Gao, Deye Yang, Ye Yang, Guoqiang Wan
Ribbon synapses in the cochlear hair cells are subject to extensive pruning and maturation processes before hearing onset. Previous studies have highlighted the pivotal role of thyroid hormone (TH) in this developmental process, yet the detailed mechanisms are largely unknown. In this study, we found that the thyroid hormone receptor α (Thrα) is expressed in both sensory epithelium and spiral ganglion neurons in mice. Hypothyroidism, induced by Pax8 gene knockout, significantly delays the synaptic pruning during postnatal development in mice...
February 21, 2024: Biochemical and Biophysical Research Communications
#6
EDITORIAL
Antonio C Bianco, Colin M Dayan, Jacqueline Jonklaas
No abstract text is available yet for this article.
2024: Frontiers in Endocrinology
#7
JOURNAL ARTICLE
Roberto Attanasio, Miloš Žarković, Enrico Papini, Endre V Nagy, Roberto Negro, Petros Perros, Ersin Akarsu, Maria Alevizaki, Göksun Ayvaz, Tomasz Bednarczuk, Biljana Beleslin, Eszter Berta, Miklos Bodor, Anna Maria Borissova, Mihail Boyanov, Camille Buffet, Maria-Cristina Burlacu, Jasmina Ciric, Juan J Díez, Harald Dobnig, Valentin V Fadeyev, Benjamin Ct Field, Eric Fliers, Dagmar Führer, Juan Carlos Galofré, Tommi Hakala, Jan Jiskra, Peter A Kopp, Michael Krebs, Michal Kršek, Martin Kuzma, Mikael Lantz, Ivica Lazúrová, Laurence Leenhardt, Vitaliy Luchytskiy, Francisca Marques Puga, Anne McGowan, Saara Metso, Carla Moran, Tatyana Morgunova, Dan Alexandru Niculescu, Božidar Perić, Tereza Planck, Catalina Poiana, Eyal Robenshtok, Patrick Olivier Rosselet, Marek Ruchala, Kamilla Ryom Riis, Alla Shepelkevich, Mykola D Tronko, David Unuane, Irfan Vardarli, W Edward Visser, Andromachi Vryonidou, Younes Ramazan Younes, Laszlo Hegedus
BACKGROUND: Hypothyroidism is common, however, aspects of its treatment remain controversial. Our survey aimed at documenting treatment choices of European thyroid specialists and exploring how patients' persistent symptoms, clinician demographics, and geo-economic factors relate to treatment choices. METHODS: 17,247 thyroid specialists from 28 countries were invited to participate in an online questionnaire survey. The survey included respondent demographic data and treatment choices for hypothyroid patients with persistent symptoms...
February 18, 2024: Thyroid: Official Journal of the American Thyroid Association
#8
Thyroid hormone resistance and large goiter mimicking infiltrative carcinoma in a pediatric patient.
Carly Baxter, Claudia Martinez-Rios, Alexandra Ahmet
BACKGROUND: Resistance to thyroid hormone (RTH) is a genetic condition, caused by mutations in the thyroid hormone receptor gene and characterized by impaired end organ responsiveness to thyroid hormone. Here we describe a novel case of THR associated with large goiter mimicking infiltrative c. CASE PRESENTATION: A 13-year-old male with a hyperthyroid phenotype of RTH diagnosed as a toddler, on methimazole and nadolol therapies presented with an increase in goiter size and possible nodule...
January 25, 2024: Journal of Pediatric Endocrinology & Metabolism: JPEM
#9
RANDOMIZED CONTROLLED TRIAL
Giulia Brigante, Daniele Santi, Gisella Boselli, Gianluca Margiotta, Rossella Corleto, Maria Laura Monzani, Andrea Craparo, Michela Locaso, Samantha Sperduti, Neena Roy, Livio Casarini, Tommaso Trenti, Simonetta Tagliavini, Maria Cristina De Santis, Laura Roli, Vincenzo Rochira, Manuela Simoni
OBJECTIVE: Despite having normal thyroid-stimulating hormone levels, many hypothyroid patients are dissatisfied with the treatment. The primary aim of this study was to evaluate the effect of twice-daily, combination therapy with levothyroxine (LT4) and liothyronine (LT3), at doses adapted according to TSH-level, on peripheral tissues as reflected by sex hormone binding globulin (SHBG) levels in totally thyroidectomized patients. Changes in other tissue markers and quality of life considering DIO2-rs225014 and MCT10-rs17606253 genetic variants were also assessed...
January 3, 2024: European Journal of Endocrinology
#10
JOURNAL ARTICLE
Agathoklis Efthymiadis, Matthew Henry, Dimitrios Spinos, Marianthi Bourlaki, Alexandros Tsikopoulos, Angeliki Bourazana, Anastasios Bastounis, Konstantinos Tsikopoulos
OBJECTIVE: Thyroid hormone under-replacement and over-replacement are associated with adverse health outcomes. This systematic review aimed to evaluate the extent of thyroid hormone replacement adequacy for patients with known hypothyroidism in real-word settings, excluding those receiving thyroid hormone suppressive therapy as thyroid cancer treatment. DESIGN: Four electronic databases (Embase [Ovid], Medline [Ovid], PubMed and SCOPUS) were searched for published and unpublished observational studies until 12 December 2022...
November 30, 2023: Clinical Endocrinology
#11
REVIEW
Lakdasa D Premawardhana, Peter Nicholas Taylor, Onyebuchi E Okosieme, Mohamed A Adlan, Emmanuel K Obuobie, Colin Mark Dayan
Approximately 10%-15% of subjects with hypothyroidism on L-thyroxine (LT4) alone have persistent symptoms affecting their quality of life (QoL). Although the cause is unclear, there is evidence that "tissue T3 lack" may be responsible. If so, combining liothyronine (LT3) with LT4 would be helpful. However, randomized controlled trials (RCT), have not established greater efficacy for the LT3 + LT4 combination in these subjects than for LT4 alone. While the trial design may have been responsible, the use of unphysiological, short-acting LT3 preparations and non-thyroid-specific patient-reported outcome measures (PROMs) may have contributed...
2023: Frontiers in Endocrinology
#12
Ashutosh Kapoor, Zin Htut, Chukwuma Uduku
Primary hypothyroidism is a commonly encountered endocrine disorder and can be associated with pericardial effusion and cardiac tamponade in severe cases. Early detection of hypothyroidism is key since it is a potentially treatable and reversible cause of pericardial effusions. A 53-year-old female was admitted following a fall. The clinical history was remarkable, with symptoms of persistent tiredness and fatigue for six months. She had no known medical conditions and was not taking any regular medications...
October 2023: Curēus
#13
JOURNAL ARTICLE
Li Yuan, Dongdong Xiao, Rumei Yang, Lei Ge, Yuye Wan, Lianglei Jiang
OBJECTIVE: The present study aimed to elucidate mechanisms of liothyronine on the treatment of ischemic stroke (IS). METHODS: Differential analysis based on R limma package was used to identify differentially expressed genes, which were then mapped into the connectivity map database for identification of liothyronine associated with IS. Tumor necrosis factor (TNF) signaling pathway was verified through pathway enrichment analysis via Enrichr online. Ischemia stroke mouse model was built up for further analysis...
November 29, 2023: Environmental Toxicology
#14
JOURNAL ARTICLE
Gustavo C Penna, Antonio C Bianco, Matthew D Ettleson
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 US. OBJECTIVE: To assess healthcare utilization related to cardiovascular disease (CVD) and bone health (BH) events (atrial fibrillation [AF], heart failure [HF], myocardial infarction [MI], stroke, and osteoporosis/fractures [FX]) in participants taking LT4 + LT3 or DTE surveyed in the Medical Expenditure Panel Survey (MEPS) database...
October 25, 2023: Journal of Clinical Endocrinology and Metabolism
#15
EDITORIAL
Jacqueline Jonklaas
No abstract text is available yet for this article.
October 3, 2023: Expert Review of Endocrinology & Metabolism
#16
Youngha Choi, Se Yong Jung, Jung Min Park, Junghwan Suh, Eun Jung Shin, Hyun Wook Chae, Ho-Seong Kim, Ahreum Kwon
No abstract text is available yet for this article.
September 2023: Annals of Pediatric Endocrinology & Metabolism
#17
JOURNAL ARTICLE
Jessica F Cassemiro, Veronica Ilera, Stella Batalles, Adriana Reyes, Endre V Nagy, Enrico Papini, Petros Perros, Laszlo Hegedüs, Helton Estrela Ramos
PURPOSE: Inconsistencies in the medical management of hypothyroidism have been reported between endocrinologists in different countries. This study aimed to identify the attitudes of Latin America thyroid specialists towards the use of thyroid hormones. METHODS: Online survey of members of the Latin America Thyroid Society. RESULTS: 81/446 (18.2%) completed the questionnaire. Levothyroxine (LT4) was the initial treatment of choice for all respondents...
September 29, 2023: Thyroid Research
#18
REVIEW
Antonio C Bianco
Levothyroxine (LT4) is effective for most patients with hypothyroidism. However, a minority of the patients remain symptomatic despite the normalization of serum thyrotropin levels. Randomized clinical trials including all types of patients with hypothyroidism revealed that combination levothyroxine and liothyronine (LT4+LT3) therapy is safe and is the preferred choice of patients versus LT4 alone. Many patients who do not fully benefit from LT4 experience improved quality of life and cognition after switching to LT4+LT3...
September 22, 2023: Annual Review of Medicine
#19
RANDOMIZED CONTROLLED TRIAL
Bernadette Biondi, Martina Pucci, Gilda Pontieri, Pietro Formisano, Roberta Esposito
Background: Evidence is needed on the risks and benefits of combination therapy with levothyroxine (LT4)+liothyronine (LT3) for the treatment of hypothyroidism. Objective and Methods: We performed a randomized, double-blind placebo-controlled study to assess the effects of LT4+LT3 therapy versus LT4+placebo in a homogeneous group of athyreotic patients, without cardiovascular risk factors during long-term replacement monotherapy with LT4. The primary objective of the study was to assess the effects of combination LT4+LT3 therapy on heart rate, cardiac rhythm, and sensitive cardiovascular parameters of cardiac morphology and function by means of electrocardiography and Doppler echocardiography...
December 2023: Thyroid: Official Journal of the American Thyroid Association
#20
Mehul S Amin, Umesh Kumar Pabani, Sunaina Lohano, Zahid Khan
Myxedema coma is a rare and life-threatening manifestation of severe hypothyroidism. Myxedema refers to altered mental status observed in these patients. Clinical characteristics observed include hypothermia, bradycardia, respiratory failure, hyponatremia, and altered mental status. We present the case of a 57-year-old female who was brought into the hospital with a history of collapse and a long lie. On initial assessment, she was hypothermic, hypotensive, bradycardic, and hypoglycemic with elevated infection markers, acute kidney injury, and electrolyte derangement...
August 2023: Curēus
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