Endocrine Abstracts

Introduction: Part of the long-term management of patients with differentiated thyroid cancer (DTC) is TSH suppression with supraphysiological doses of levothyroxine. Anecdotal experience suggests that GPs often are not aware of the differences in objectives between treating patients with DTC with suppressive doses of thyroxine and treating patients with primary hypothyroidism, thus leading to inappropriate adjustments of the dose of levothyroxine.

Objectives: To obtain information from patients with DTC on the prevalence of this problem and its impact on patient care.

Methodology: A questionnaire was distributed to patients DTC attending our joint thyroid cancer clinic.

Results: A total of 49 responses were received. About 35% (17/49) of patients stated that since diagnosis, they had received conflicting advice from their GPs compared to the Thyroid Cancer Clinic staff with regards to the dose of levothyroxine. The Impact on the 17 patients who were affected was as follows: ‘felt confused’ 59% (10/17); ‘was worried’ 41% (7/17); ‘lost of confidence in docs’ 59% (10/17), ‘had to take time off work’ 24% (4/17), ‘gained weight’ 48% (8/17).

Conclusion: Inappropriate adjustment of thyroxine therapy of patients with DTC in primary care, is a common occurrence and represents bad practice. The impact on patient care is substantial. Effective strategies to address this problem are required to improve patient care.