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Lookup NU author(s): Dr Petros PerrosORCiD
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© 2022 Thieme Medical Publishers, Inc.. All rights reserved. Objective To identify the attitudes of German thyroid specialists towards the clinical treatment of hypothyroidism using thyroid hormones (TH). Methods All members of the thyroid section of the German Endocrine Society (DGE) were e-mailed an invitation to participate in a web-based survey about substitution with TH. Results Out of 206 members of the DGE's thyroid section, 163 (79.1%) responses were received and included in the analysis. Of responding members, 98.6% used levothyroxine (LT4) as the treatment of choice, and 45.4% also prescribed combination therapy with liothyronine (LT4+LT3) in their clinical practice (p<0.001). LT4+LT3 combination was favored in patients with persistent hypothyroidism symptoms despite biochemical euthyroidism on LT4 treatment (p<0.001). Of all respondents, 26.4% never indicated TH therapy for euthyroid patients (p<0.001), while the remainder would consider THs for one or more indications (62.9% for euthyroid infertile women with high anti-thyroid antibody levels (p<0.001), 7.1% in patients with severe hypercholesterolemia, as complementary treatment (p=0.007), and 57.1% in patients with simple goiter (p<0.001)). In conditions that could interfere with LT4 absorption, most respondents still preferred tablets and did not expect a significant difference when switching from one LT4 formulation to another. Conclusion For German thyroid specialists, LT4 is the treatment of choice for hypothyroidism. Combination therapy with LT4+LT3 was considered for patients with persistent symptoms. Even in conditions that could affect bioavailability, German thyroid specialists prefer LT4 tablets rather than other LT4 formulations, such as liquid or soft-gel capsules. The widespread use of thyroid hormone for non-hypothyroid conditions is not consistent with current evidence and needs further study.
Author(s): Vardarli I, Brandenburg T, Hegedus L, Attanasio R, Nagy E, Papini E, Perros P, Weidemann F, Herrmann K, Fuhrer D
Publication type: Article
Publication status: Published
Journal: Experimental and Clinical Endocrinology and Diabetes
Year: 2022
Volume: 130
Issue: 09
Pages: 577-586
Print publication date: 01/09/2022
Online publication date: 31/05/2022
Acceptance date: 04/04/2022
ISSN (print): 0947-7349
ISSN (electronic): 1439-3646
Publisher: Georg Thieme Verlag
URL: https://doi.org/10.1055/a-1832-0644
DOI: 10.1055/a-1832-0644
PubMed id: 35640637
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