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Lookup NU author(s): Dr Petros PerrosORCiD
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).
© 2024 The Authors. Clinical Endocrinology published by John Wiley & Sons Ltd.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. Measurements: We analysed questionnaires that had complete demographic data. Results: Eighty-seven questionnaires fulfilled the criteria. LT4 was used as first line treatment for hypothyroidism by all respondents. Only 45% reported that their patients were dispensed the brand of LT4 that they recommend. LT3 (alone or in combination) was prescribed by 44% in their clinical practice. Although 49% of respondents would consider LT3 + LT4 in patients with normal TSH who had ongoing symptoms of hypothyroidism, the inability of LT4 to restore normal physiology was ranked the least likely explanation for persistent symptoms and only 32% would consider it for themselves if they were diagnosed with hypothyroidism. The majority (55%), in accordance with evidence, would not prescribe thyroid hormone to euthyroid individuals but 39% would consider use in euthyroid female infertility with high levels of thyroid antibodies and 11% in euthyroid patients with a simple goitre growing over time. LT4 use in pregnancy was variable among members. Conclusions: Australian endocrinologists mostly follow international guidelines when prescribing thyroid hormone therapy and many prescribe combination LT3 and LT4 therapy, particularly for patients who remain symptomatic on LT4 monotherapy. Prescribing practices are largely similar to other countries who have completed similar questionnaires.
Author(s): Lafontaine N, Brown SJ, Perros P, Papini E, Nagy EV, Attanasio R, Hegedus L, Walsh JP
Publication type: Article
Publication status: Published
Journal: Clinical Endocrinology
Year: 2024
Volume: 100
Issue: 5
Pages: 477-485
Print publication date: 01/05/2024
Online publication date: 11/03/2024
Acceptance date: 27/02/2024
Date deposited: 25/03/2024
ISSN (print): 0300-0664
ISSN (electronic): 1365-2265
Publisher: John Wiley and Sons Inc
URL: https://doi.org/10.1111/cen.15049
DOI: 10.1111/cen.15049
Data Access Statement: The data sets generated and analysed during this study are not publicly available but may be accessed through the corresponding author on reasonable request.
PubMed id: 38462996
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