Endocrine Abstracts

Objectives: Bariatric surgery significantly impacts various aspects of health, including thyroid function. Despite this, there is a lack of clear data on whether patients taking levothyroxine should adjust their dosing regimen following weight loss post-bariatric surgery. Bariatric surgery alters the anatomy of the gastrointestinal tract, potentially affecting medication absorption, including levothyroxine. Procedures such as gastric bypass and sleeve gastrectomy can lead to c...

Despite normalized serum thyroid hormone levels, 10% of hypothyroid patients treated with levothyroxine (LT4) have persistent complaints, of which tiredness is the most commonly reported. This could be explained by the fact that the physiological T4/T3 ratio is not achieved with LT4 monotherapy. Studies have reported contradicting results as to whether the addition of liothyronine (LT3) is effective in relieving these persistent complaints. However, all of these studies suffer...

Primary hypothyroidism is a frequent disease and oral levothyroxine is the mainstay of its treatment. However, more than 20% of levothyroxine-treated patients fail to achieve the recommended serum TSH level with a body weight–based dose of levothyroxine. Refractory hypothyroidism is due to either malabsorption or nonadherence. In clinical practice, a levothyroxine absorption test is part of the workup of a refractory hypothyroid patient for confirming normal levothyroxine...

Riedel’s thyroiditis (RT) is a rare, inflammatory-sclerosing disease of the thyroid gland, with dense fibrosis that replaces normal thyroid tissue and local extension to surrounding structures causing hypothyroidism and compressive symptoms. The etiology of RT remains unknown, and its treatment is still challenging in absence of guideline consensus. We report 7 patients seen in a department of Endocrinology between 2000 and 2023: 5 women and 2 men, mean age 46 (20–81...

Objectives: An improvement in iodine status in Veneto region has been documented in the last decade. We aimed at estimating the incidence of autoimmune hypotiroidism (AH) in the Veneto Region over the period 2013-2022.Methods: Retrospective population-based study conducted in Veneto (4.9 million people) using the population registry, an administrative health database. Between 2012 and 2022, AH incidence was defined thank to a health-care co-payment exemp...

Background: Levothyroxine (LT4) is one of the most commonly prescribed drugs in the western world. Approximately half a million people of the Dutch population use LT4 therapy and are thus instructed to ingest LT4 in a fasting state. Yet, postponing breakfast seems to be challenging for many patients and appears to be an important reason for suboptimal adherence to LT4 therapy. In this study, we aimed to determine the impact on daily life of postponing breakfast in a LT4-using ...

Background: Some evidence indicates how bariatric surgery impacts the thyroid function test and, in hypothyroid patients, the dose of levothyroxine (LT4), but data are not univocal. Aim: To examine, in a single center retrospective analysis, the relationship between change in body weight, plasma levels of TSH and dosage of LT4 in patients with thyroid disease undergoing bariatric surgery and to compare the effects of Roux-en-Y gastric bypass (RYGB) vs sleeve gastrectomy (SG).<...

Background and aims: Hypothyroidism is high frequent affecting overall women and subjects over 60 years of age. It is usually treated by the administration of Levothyroxine (L-T4) under different formulations, and the tablet formulation is the most common used. The objective is reaching stable thyroid-stimulating hormone (TSH) levels, the patients are monitored by an annual test of the TSH levels to adjust the therapy, if necessary. We aimed to evaluate the efficacy of L-T4 th...

Background: Desiccated thyroid extract (DTE) is derived from the porcine thyroid gland, which has a higher triiodothyronine content than the human thyroid gland. DTE was standard therapy for hypothyroidism until the mid-1970s and is still in use, even though it is not recommended in current guidelines. This review aimed to summarize the available literature on DTE treatment in adult hypothyroid patients.Methods: The search was conducted in six electronic...

Background: A debate is active on the capability to restore euthyroidism in people with hypothyroidism (hT) since symptoms and metabolic abnormalities experienced by some patients. This issue has been mainly studied by focusing on the lower stream of the Hypothalamus–Pituitary-Thyroid (HPT) axis by TSH, FT4 and FT3 levels. It would be useful to focus on the upper part of the flow of HPT axis, investigating the factors that interfere with the hypothalamic-pituitary thyrotr...