Endocrine Abstracts

Objectives: We present findings from the UK arm of the THESIS collaboration, a pan-European survey of endocrinologists’ opinions and current practice in the management of hypothyroid and euthyroid disorders.

Methods: UK clinical members of the Society of Endocrinology and the British Thyroid Association were invited to participate in an online survey.

Results: 272 of 1295 (21%) eligible members completed the survey. More than 50% of respondents stated that combined treatment with levothyroxine + liothyronine could be considered for levothyroxine-treated patients whose symptoms persist despite normalisation of serum thyroid stimulating hormone (TSH) concentration. However, only 40% are currently prescribing such treatment, and just 23% would consider taking it themselves. Endocrinologists who reported managing larger numbers of patients with hypothyroidism were more likely than those managing smaller numbers to consider prescribing combined levothyroxine + liothyronine (>100 patients annually, 65%; 51–100 patients annually, 54%; ≤50 patients annually, 48%; P = 0.0302). Just 5.4% prescribe desiccated thyroid extract, and those most likely to do so are aged over 60 years (P = 0.043). 27% would recommend levothyroxine for euthyroid female infertility with high titre thyroid peroxidase antibodies, despite recent trials finding no benefit. Most respondents stated that they have no influence over brand or formulation of levothyroxine dispensed to their patients and expect no major differences in efficacy between formulations.

Conclusions: For UK endocrinologists, the role of combined levothyroxine + liothyronine in treatment of hypothyroidism remains a live issue for further research, brought into focus recently by the cost-led withdrawal of access to liothyronine in many regions. The importance of facilitating efficient dissemination of research findings in the UK is highlighted by the proportion of respondents who would currently consider prescribing thyroid hormone treatment in euthyroid female infertility with high titre antibodies, an indication for which evidence of efficacy is lacking.