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Liothyronine

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https://www.readbyqxmd.com/read/28632526/persistent-hypothyroid-symptoms-in-a-patient-with-a-normal-thyroid-stimulating-hormone-level
#1
Jacqueline Jonklaas
PURPOSE OF REVIEW: A subset of patients being treated for hypothyroidism do not feel well while taking levothyroxine (LT4) replacement therapy, despite having a normal serum thyroid stimulating hormone level. Pursuing a relative triiodothyronine deficiency as a potential explanation for patient dissatisfaction, has led to trials of combination therapy with liothyronine (LT3), with largely negative outcomes. This review attempts to reconcile these diverse findings, consider potential explanations, and identify areas for future research...
June 16, 2017: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/28620499/intrauterine-death-following-intraamniotic-triiodothyronine-and-thyroxine-therapy-for-fetal-goitrous-hypothyroidism-associated-with-polyhydramnios-and-caused-by-a-thyroglobulin-mutation
#2
Pradeep Vasudevan, Corrina Powell, Adeline K Nicholas, Ian Scudamore, James Greening, Soo-Mi Park, Nadia Schoenmakers
In the absence of maternal thyroid disease or iodine deficiency, fetal goitre is rare and usually attributable to dyshormonogenesis, for which genetic ascertainment is not always undertaken in the UK. Mechanical complications include tracheal and oesophageal compression with resultant polyhydramnios, malpresentation at delivery and neonatal respiratory distress. We report an Indian kindred in which the proband (first-born son) had congenital hypothyroidism (CH) without obvious neonatal goitre. His mother's second pregnancy was complicated by fetal hypothyroid goitre and polyhydramnios, prompting amniotic fluid drainage and intraamniotic therapy (with liothyronine, T3 and levothyroxine, T4)...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28599168/impurity-profiling-of-liothyronine-sodium-by-means-of-reversed-phase-hplc-high-resolution-mass-spectrometry-on-line-h-d-exchange-and-uv-vis-absorption
#3
M Ruggenthaler, J Grass, W Schuh, C G Huber, R J Reischl
For the first time, a comprehensive investigation of the impurity profile of the synthetic thyroid API (active pharmaceutical ingredient) liothyronine sodium (LT3Na) was performed by using reversed phase HPLC and advanced structural elucidation techniques including high resolution tandem mass spectrometry (HRMS/MS) and on-line hydrogen-deuterium (H/D) exchange. Overall, 39 compounds were characterized and 25 of these related substances were previously unknown to literature. The impurity classification system recently developed for the closely related API levothyroxine sodium (LT4Na) could be applied to the newly characterized liothyronine sodium impurities resulting in a wholistic thyroid API impurity classification system...
September 5, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/28589090/neither-baseline-nor-changes-in-serum-triiodothyronine-during-levothyroxine-liothyronine-combination-therapy-predict-a-positive-response-to-this-treatment-modality-in-hypothyroid-patients-with-persistent-symptoms
#4
Bjarke Borregaard Medici, Jeppe Lerche la Cour, Luba Freja Michaelsson, Jens Oscar Faber, Birte Nygaard
BACKGROUND: Despite biochemical euthyroidism, some levothyroxine (L-T4)-treated hypothyroid patients report persisting symptoms and some of these patients are tentatively treated with a combination of L-T4 and liothyronine (L-T3). Combination therapy and the appropriate choice of blood tests to monitor treatment are highly debated among specialists and patients. AIM: To evaluate whether measuring serum triiodothyronine (S-T3) at baseline or during combination therapy can be used as an indicator of a positive effect from L-T4/L-T3 combination therapy...
April 2017: European Thyroid Journal
https://www.readbyqxmd.com/read/28584694/liothyronine-for-depression-a-review-and-guidance-for-safety-monitoring
#5
REVIEW
Katie T B Touma, Allysa M Zoucha, Jonathan R Scarff
Objective: The objective of this review is to discuss triiodothyronine's (T3, liothyronine) mechanism of action, efficacy in enhancement and augmentation trials, and dosing and safety considerations for the treatment of depression. Method: A literature search of PubMed was performed using search terms depression, augmentation, antidepressant, and liothyronine. Only English-language studies of subjects with unipolar depression were included from the past 50 years. Results: Most studies have shown that liothyronine is an efficacious enhancement and augmentation strategy for depression in combination with antidepressants, primarily tricyclic antidepressants and selective serotonin reuptake inhibitors...
March 2017: Innovations in Clinical Neuroscience
https://www.readbyqxmd.com/read/28420821/use-of-liothyronine-without-levothyroxine-in-the-treatment-of-mild-consumptive-hypothyroidism-caused-by-hepatic-hemangiomas
#6
Shinji Higuchi, Masaki Takagi, Yukihiro Hasegawa
There have been reports of the use of levothyroxine or levothyroxine plus liothyronine for consumptive hypothyroidism caused by hepatic hemangiomas. Administration of levothyroxine without liothyronine can be inadequate to maintain normal levels of both free T3 and free T4 in some patients. However, there is no report of treatment with liothyronine plus propranolol. We herein present a case in which we used liothyronine therapy for multifocal hepatic hemangiomas in a Japanese patient with low free T3 and normal free T4 levels...
April 18, 2017: Endocrine Journal
https://www.readbyqxmd.com/read/27982198/treatment-of-hypothyroidism-with-levothyroxine-plus-liothyronine-a-randomized-double-blind-crossover-study
#7
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/27902975/timing-of-hormone-withdrawal-in-children-undergoing-131i-whole-body-scans-for-thyroid-cancer
#8
Sophie Turpin, Raymond Lambert, Cheri Deal
BACKGROUND: Little objective pediatric data exist to guide the optimal time needed to achieve thyroid-stimulating hormone (TSH) levels ≥30 μIU/mL prior to performing 131I or 123I whole-body scan (WBS) imaging in children with thyroid cancer in the post-thyroidectomy period or after hormone discontinuation. METHODS: Retrospective study of patients aged 5-19 years who underwent WBS. Patient data collection included type and duration of withdrawal (liothyronine [L-T3], levothyroxine [L-T4], or post-thyroidectomy status without hormonal replacement) and TSH measured prior to WBS (level and timing)...
2016: Hormone Research in Pædiatrics
https://www.readbyqxmd.com/read/27178621/liothyronine-improves-biochemical-control-of-congenital-hypothyroidism-in-patients-with-central-resistance-to-thyroid-hormone
#9
Laura Paone, Abby F Fleisch, Henry A Feldman, Rosalind S Brown, Ari J Wassner
OBJECTIVE: To assess whether adding liothyronine (LT3) to levothyroxine (LT4) monotherapy normalizes serum thyrotropin (TSH) and thyroxine (T4) concentrations in children with congenital hypothyroidism and central resistance to thyroid hormone. STUDY DESIGN: We retrospectively studied 12 patients with congenital hypothyroidism and central resistance to thyroid hormone (6 treated with LT3+LT4 combined therapy and 6 treated with LT4 monotherapy). In patients receiving combined therapy, we compared serum concentrations of TSH, T4, and triiodothyronine before and after addition of LT3...
August 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27137849/risks-and-safety-of-combination-therapy-for-hypothyroidism
#10
REVIEW
Jacqueline Jonklaas
INTRODUCTION: Hypothyroidism is currently a condition that can be treated, but not cured. Although levothyroxine reverses stigmata of hypothyroidism in most individuals, some patients feel dissatisfied with 'monotherapy', and this has stimulated interest in 'combination therapy' with both levothyroxine and liothyronine. AREAS COVERED: A search of PubMed was conducted using terms including hypothyroidism, treatment, benefits, risks, and safety. Based on the articles identified, the body of evidence regarding the efficacy of traditional levothyroxine is reviewed...
August 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27126268/thyroxine-replacement-a-clinical-endocrinologist-s-viewpoint
#11
REVIEW
V Eligar, P N Taylor, O E Okosieme, G P Leese, C M Dayan
BACKGROUND: Hypothyroidism affects 2-5% of the general population. Patients with uncorrected disease suffer significant morbidity and have an increased risk of cardiovascular disease and neurocognitive impairment. Levothyroxine, the treatment of choice, is inexpensive, easy to administer and in most cases restores well-being while normalizing thyroid function. However, 30-50% of individuals on levothyroxine are either over-treated or under-treated and others remain dissatisfied with treatment despite achieving thyroid hormone concentrations within the laboratory reference interval...
July 2016: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/27030088/daily-administration-of-short-acting-liothyronine-is-associated-with-significant-triiodothyronine-excursions-and-fails-to-alter-thyroid-responsive-parameters
#12
Jacqueline Jonklaas, Kenneth D Burman
BACKGROUND: Although most studies of levothyroxine-liothyronine combination therapy employ once-daily hormone administration, the kinetics of once-daily liothyronine have been studied infrequently. The aim of this study was to document both the peak and trough serum triiodothyronine (T3) levels that occur with once-daily liothyronine administration, along with changes in thyroid-responsive parameters. METHODS: Participants with hypothyroidism were studied prospectively at an academic institution...
June 2016: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/27000530/liquid-liothyronine-to-obtain-target-tsh-in-differentiated-thyroid-cancer-patients
#13
Pierpaolo Trimboli, Marco Centanni, Camilla Virili
In the last ten years a liquid formulation of liothyronine (L-T3) became available. To date, no studies on its systematic use have been reported. This study is aimed at assessing the reliability of liquid L-T3 in achieving target TSH in patients with differentiated thyroid cancers (DTC). Twenty-one high risk DTC patients in whom levothyroxine treatment up to 2.0 μg/kg/day did not suppress TSH levels (i.e. >0.1 mIU/L) were selected. Maintaining the same L-T4 dose, they started to assume liquid L-T3 at an initial fixed dose of 3...
June 30, 2016: Endocrine Journal
https://www.readbyqxmd.com/read/26940864/liothyronine-use-in-a-17-year-observational-population-based-study-the-tears-study
#14
Graham P Leese, Enrique Soto-Pedre, Louise A Donnelly
OBJECTIVE: To look at adverse outcomes for patients on liothyronine compared to l-thyroxine. Some trials have examined the relative merits of liothyronine but none have looked at adverse outcomes in large numbers. STUDY DESIGN: An observational study of all patients prescribed thyroid hormone replacement in Tayside Scotland (population 400 000) from 1997 to 2014. PATIENTS: A study group of patients having ever used liothyronine (n = 400) was compared to those who had only used l-thyroxine (n = 33 955)...
December 2016: Clinical Endocrinology
https://www.readbyqxmd.com/read/26654514/a-systematic-review-of-clinical-practice-guidelines-recommendations-on-levothyroxine-therapy-alone-versus-combination-therapy-lt4-plus-lt3-for-hypothyroidism
#15
REVIEW
Eyal Kraut, Pendar Farahani
PURPOSE: Patients with hypothyroidism are increasingly enquiring about the benefit of using combination therapy of levothyroxine (LT4) and liothyronine (LT3) as a potential treatment for hypothyroidism. Combination therapy, however, remains controversial. The purpose of this study was to systematically review available hypothyroidism treatment recommendations from clinical practice guidelines from around the world to identify the consensus regarding combination therapy. SOURCE: Clinical practice guidelines were obtained from searches of PubMed, EMBASE, and MEDLINE, using several combinations of MeSH terms...
December 4, 2015: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
https://www.readbyqxmd.com/read/26618010/weekly-intramuscular-injection-of-levothyroxine-following-myxoedema-a-practical-solution-to-an-old-crisis
#16
Peter N Taylor, Arshiya Tabasum, Gina Sanki, David Burberry, Brian P Tennant, James White, Onyebuchi Okosieme, Andrew Aldridge, Gautam Das
An 82-year-old female with known hypothyroidism was admitted to hospital after being found on the floor. On examination, she was unkempt, confused, bradycardic, hypothermic, and barely arousable. Initial biochemistry revealed a thyroid stimulating hormone (TSH) of >100 mU/L and free thyroxine (FT4) level of 1.5 pmol/L which supported a diagnosis of myxoedema coma. She was resuscitated and commenced on liothyronine, levothyroxine, and hydrocortisone and some improvement was made. It became apparent that she was hiding and spitting out her oral levothyroxine including levothyroxine elixir...
2015: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/26558234/treating-hypothyroidism-with-thyroxine-triiodothyronine-combination-therapy-in-denmark-following-guidelines-or-following-trends
#17
Luba Freja Michaelsson, Bjarke Borregaard Medici, Jeppe Lerche la Cour, Christian Selmer, Michael Røder, Hans Perrild, Nils Knudsen, Jens Faber, Birte Nygaard
BACKGROUND: Five to ten percent of patients with hypothyroidism describe persistent symptoms despite being biochemically well regulated on levothyroxine (L-T4). Thyroxine (T4)/triiodothyronine (T3) combination therapy [L-T4/liothyronine (L-T3) or desiccated thyroid] are still regarded as experimental with no evidence of superior effect on persistent symptoms according to meta-analyses. However, some randomized controlled trials have demonstrated patients' preference for T4/T3 combination therapy as compared to L-T4 monotherapy...
September 2015: European Thyroid Journal
https://www.readbyqxmd.com/read/26544166/update-on-the-treatment-of-hypothyroidism
#18
REVIEW
Jacqueline Jonklaas
PURPOSE OF REVIEW: Differentiated thyroid cancer is a malignancy that is rapidly increasing in frequency. As thyroidectomy plays a central role in the treatment of thyroid cancer, it is incumbent on physicians treating this patient group to be well versed in the intricacies of treating hypothyroidism. RECENT FINDINGS: Treatment of hypothyroidism may be refined by careful attention to dose selection, monitoring of therapy and achievement of thyrotropin goals that are specific to the individual patient's overall clinical situation...
January 2016: Current Opinion in Oncology
https://www.readbyqxmd.com/read/26403562/combination-levothyroxine-liothyronine-treatment-in-pregnancy
#19
REVIEW
Megan E Foeller, Robert M Silver
Hypothyroidism is one of the most common endocrine disorders in young women and affects 3% to 4% of all pregnancies. Inadequately treated maternal hypothyroidism is associated with numerous adverse fetal and maternal outcomes. Because of growing popularity of levothyroxine (L-T4) + liothyronine (L-T3) combination therapy for hypothyroidism in nonpregnant individuals, pregnant women are taking these medications with increasing frequency. This article reviews the theoretical dangers of combination L-T4 + L-T3 treatment during pregnancy by outlining physiological regulation of maternal and fetal thyroid homeostasis, proposed adverse fetal outcomes to combination therapy, and current recommendations on thyroid replacement in pregnancy from professional societies...
September 2015: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/26305055/analysis-of-40-weight-loss-compounds-adulterated-in-health-supplements-by-liquid-chromatography-quadrupole-linear-ion-trap-mass-spectrometry
#20
Yun Zeng, Yimin Xu, Chee-Leong Kee, Min-Yong Low, Xiaowei Ge
In this study, a liquid chromatography-tandem mass spectrometry (LC-MS/MS) with scheduled multiple reaction monitoring (MRM) enhanced product ion (EPI) method was developed for simultaneous determination of 40 compounds with weight loss effect, including bisacodyl, phenolphthalein, and sibutramine and its metabolites, etc. They might be adulterated in health supplements to get prominent weight loss effect. The samples were analyzed using a Q-Trap 5500 coupled with high performance liquid chromatography (HPLC) and a CORTECS ultra performance liquid chromatography (UPLC) C18 column (100 mm x 2...
March 2016: Drug Testing and Analysis
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