Endocrine Abstracts

Introduction: The problem of postoperative hypothyroidism has the same long history as thyroid surgery. Levothyroxine monotherapy is the treatment of choice for hypothyroid patients because peripheral T₄ to T₃ conversion is supposed to account for the overall tissue requirement for thyroid hormones.

The aim of this retrospective study conducted in the hospital is to evaluate the effectiveness of levothyroxine monotherapy in patients undergoing thyroidectomy.

Materials and methods: The study included 42 patients after thyroidectomy with normal levels of TSH (1–3 mU/l) on the background of levothyroxine monotherapy (all of them were treated with 1.5 mg/kg per day dosage for at least 2 months); and 85 of them, with euthyroid, belonged to a control group. The determining of TSH, FT₄ and FT₃ in serum by immunochemical analysis has been conducted through 2 weeks, 1–2–6–12 months after surgery.

Results: The research revealed that while prescribing levothyroxine, the increase in the concentration of FT₃ in the blood is slow and is reaches the desired parameter for full compensation of hypothyroidism only after 1–2 months. However, about 20% of levothyroxine-treated athyreotic patients FT₄ levels were 5.6% higher and FT₃ levels were 12% lower compared to the control group.

Conclusion: Therefore, levothyroxine monotherapy is effective compensation in most postoperative hypothyroid patients, but some of them need a more personal approach to replacement therapy, which can be achieved by means of postoperative monitoring.

Keywords: postoperative monitoring, replacement therapy, levothyroxine monotherapy.