Endocrine Abstracts

Background and aims

In the Republic of Belarus treatment of hypothyroidism in the adult population is regulated by the order of the Ministry of Health dated 2013. Levothyroxine is available in tablet form (dosage in increments of 25 µg). Liothyronine are not registered in the Republic of Belarus, but patients can purchase them on their own abroad. Thus, the aim was to study of possible endocrinologists’ preferences of choosing the levothyroxine formulation.

Materials and methods

From 01.10.2020 to 26.12.2020 there was survey using THESIS questionnaire: Treatment of Hypothyroidism in Europe by Specialists: International Survey (Russian version). 210 members of Belarusian Public Medical Association ’Endocrinology and Metabolism’ received the mailing with questionnaire in Word and Excel formats, agreed to participate and filled out the questionnaire. Taking into account the duration of medical practice for more than 5 years, the experience of working with patients with hypothyroidism and the mandatory specialization as an endocrinologist, 146 doctors were included in the study.

Results

132 (90.4) women and 14 (9.6%) men responded. LT4 as the first choice of the hypothyroidism therapy indicated 99.3% (145) respondents, and 0.7% (1) LT4 and LT3 combination. there was Clinical experience in prescribing LT3 was identified in 3.4% (5 persons), desiccated thyroid – 0.7% (1 person), LT4 and LT3 combination – 6.2% (9 persons). The LT4 and LT3 combined may be used in following cases: for a short period, in patients recovering from protracted hypothyroidism – 41.8% (61 responses), in patients with normal serum TSH and hypothyroidism symptoms – 10.3% (15 responses), in hypothyroid patients with normal serum TSH and unexplained weight gain – 1.4% (2 responses); never be used – 46.5% (68 responses). General clinical experience shows next form of LT4 is better absorbed: tablets 64.4% (94 responses), soft-gel capsules 4.1% (6 responses), liquid solution 4.1% (6 responses), no major changes with different formulations 27.4% (40 responses). Choice of levothyroxine formulation in patient who self-reports intolerance to various foods raising: tablets – 55.5% (81 responses), soft-gel capsules – 14.4% (21 responses), liquid solution – 14.4% (21 responses), no major changes –21.2% (31 responses). Choice of levothyroxine formulation for patient who has unexplained poor biochemical control of hypothyroidism: – tablets 78.8% (115 responses), soft-gel capsules –7.5% (11 responses), liquid solution 4.8% (7 responses), no major changes 17.1% (25 responses).

Conclusions

Based on general clinical experience, it is possible to use combination therapy with the introduction of both LT4 and LT3. The preference for alternative forms varies with clinical situations.