ECE2021 Oral Communications Oral Communications 5: Thyroid (6 abstracts)
Use of thyroid hormones in hypothyroid and euthyroid patients: A 2020 THESIS* questionnaire survey of members of the Danish Endocrine Society (*Treatment of hypothyroidism in europe by specialists: An international survey)
Kamilla Ryom Riis 1 , Jacob Froelich 1 , Laszlo Hegedüs 1 , Roberto Negro 2 , Roberto Attanasio 3 , Endre Nagy 4 , Enrico Papini 5 , Petros Perros 6 & Steen J. Bonnema 1
1Odense University Hospital, Endocrinology, Denmark; 2Division of Endocrinology, V. Fazzi Hospital, Italy; 3IRCCS Orthopedic Institute Galeazzi, Endocrinology Service; 4Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Hungary; 5Department of Endocrinology and Metabolism, Opsedale Regina Apostolorum, Italy; 6Department of Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom
Purpose
The standard treatment of hypothyroidism is levothyroxine (LT4), which is available as tablets or soft-gel capsules in Denmark. This study aimed to investigate Danish endocrinologists’ use of thyroid hormones in hypothyroid and euthyroid patients.
Method
An e-mail with an invitation to participate in an online survey investigating practices about substitution with thyroid hormones was sent to all members of the Danish Endocrine Society (DES) on 27th February 2020. The initial e-mail was followed by three reminders between February and May 2020, and where after it was closed. Survey responses were collected and electronically stored by the Lime-Survey service.
Results
Out of 488 eligible DES members, a total of 152 (31.2%) respondents were included in the analysis. The majority (94.1%) of responding DES members use LT4 as the treatment of choice. Other treatment options for hypothyroidism are also used, as 58.6% prescribe combination therapy with liothyronine (LT3)+LT4 in their clinical practice. LT4+LT3 combination is preferred in patients with persistent symptoms of hypothyroidism despite biochemical euthyroidism on LT4 treatment. Over half of the respondents answered that thyroid hormone therapy is never indicated for euthyroid patients, but 42.1% will consider it for euthyroid infertile women with high antibody levels. In various conditions that could interfere with the absorption of LT4, most responding Danish endocrinologists prefer tablets to soft-gel capsules or liquid LT4 and do not expect a significant difference when switching from one type of tablet formulation to another. The Danish endocrinologists are nearly equally divided into two categories regarding supplementation; 57 (37.5%) answered that supplementation with selenium or iodine can be used if requested by the patient, while 62 (40.8%) stated that such supplementation should never be used.
Conclusion
The treatment of choice for hypothyroidism is LT4. Combination therapy with LT4+LT3 is considered for patients with persistent symptoms. Even in the presence of conditions affecting bioavailability, responding Danish endocrinologists prefer LT4 tablets rather than newer LT4 formulations, such as soft-gel capsules.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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