Use of thyroid hormones in hypothyroid and euthyroid patients: A THESIS questionnaire survey of Serbian physicians

Introduction/Objective. Hypothyroidism is a common disease and treatment with levothyroxine (LT4) is effective. However, variations in management are frequent. The aim of this study was to identify practices and attitudes of Serbian physicians relating to the treatment of hypothyroidism. Methods. An...

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Main Authors: Nedeljković-Beleslin Biljana, Attanasio Roberto, Hegedüs Laszlo, Nagy Endre V., Negro Roberto, Papini Enrico, Perros Petros, Ćirić Jasmina, Žarković Miloš
Format: Article
Language:English
Published: Serbian Medical Society 2022-01-01
Series:Srpski Arhiv za Celokupno Lekarstvo
Subjects:
Online Access:http://www.doiserbia.nb.rs/img/doi/0370-8179/2022/0370-81792200110N.pdf
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author Nedeljković-Beleslin Biljana
Attanasio Roberto
Hegedüs Laszlo
Nagy Endre V.
Negro Roberto
Papini Enrico
Perros Petros
Ćirić Jasmina
Žarković Miloš
author_facet Nedeljković-Beleslin Biljana
Attanasio Roberto
Hegedüs Laszlo
Nagy Endre V.
Negro Roberto
Papini Enrico
Perros Petros
Ćirić Jasmina
Žarković Miloš
author_sort Nedeljković-Beleslin Biljana
collection DOAJ
description Introduction/Objective. Hypothyroidism is a common disease and treatment with levothyroxine (LT4) is effective. However, variations in management are frequent. The aim of this study was to identify practices and attitudes of Serbian physicians relating to the treatment of hypothyroidism. Methods. An anonymized questionnaire was distributed electronically to members of the Serbian Thyroid Society, Serbian Association of Endocrine Surgeons, and Section for Endocrinology of the Serbian Medical Society. Results. Out of 170 invitations, 99 responses were received. LT4 was the first choice for the treatment of hypothyroidism in 90% of patients. After starting LT4 replacement therapy most respondents would recheck thyroid-stimulating hormone (TSH) in 4–6 weeks (n = 51, 62%) and in eight weeks (n = 29, 35%). In total, 61% of respondents (n = 60) indicated that they would consider treating euthyroid patients with LT4, the commonest indication being female infertility with high levels of thyroid antibodies (54%, n = 50). More than half respondents (58%, n = 45) would recommend combined LT4 + LT3 therapy for patients on LT4 with normal serum TSH who still complain of symptoms of hypothyroidism. 53% (n = 41/77), reported that the frequency of patients with normal serum TSH who still complain of hypothyroid symptoms is less than 5%. Conclusion. LT4 was the first choice of therapy for the treatment of hypothyroid patients, whereas LT3 + LT4 combination treatment is considered in patients with persistent symptoms of hypothyroidism despite normalization of TSH. The most common indication for thyroid hormone treatment in euthyroid patients was female infertility with high levels of thyroid antibodies. Alternative LT4 formulations like liquid solution or soft-gel capsules –formulations presently not available in Serbia, were largely reserved for specific conditions (interfering drugs, malabsorption, inability to take LT4 in the fasting state, unexplained poor biochemical control of hypothyroidism).
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spelling doaj.art-0fc4461518114990a0b71edb8dfe7a852023-03-10T08:06:24ZengSerbian Medical SocietySrpski Arhiv za Celokupno Lekarstvo0370-81792406-08952022-01-0115011-1266767410.2298/SARH211221110N0370-81792200110NUse of thyroid hormones in hypothyroid and euthyroid patients: A THESIS questionnaire survey of Serbian physiciansNedeljković-Beleslin Biljana0https://orcid.org/0000-0002-1687-9297Attanasio Roberto1Hegedüs Laszlo2Nagy Endre V.3Negro Roberto4Papini Enrico5Perros Petros6Ćirić Jasmina7Žarković Miloš8University of Belgrade, Faculty of Medicine, University Clinical Centre of Serbia, Clinic of Endocrinology, Diabetes, and Metabolic Disorders, Belgrade, SerbiaAssociazione Medici Endocrinologi, Scientific Committee, Milan, ItalyOdense University Hospital, Department of Endocrinology and Metabolism, Odense, DenmarkUniversity of Debrecen, Faculty of Medicine, Department of Medicine, Division of Endocrinology, Debrecen, HungaryVito Fazzi Hospital, Division of Endocrinology, Lecce, ItalyRegina Apostolorum Hospital, Department of Endocrinology and Metabolism, Rome, ItalyRoyal Victoria Infirmary, Department of Endocrinology, Newcastle upon Tyne, United KingdomUniversity of Belgrade, Faculty of Medicine, University Clinical Centre of Serbia, Clinic of Endocrinology, Diabetes, and Metabolic Disorders, Belgrade, SerbiaUniversity of Belgrade, Faculty of Medicine, University Clinical Centre of Serbia, Clinic of Endocrinology, Diabetes, and Metabolic Disorders, Belgrade, SerbiaIntroduction/Objective. Hypothyroidism is a common disease and treatment with levothyroxine (LT4) is effective. However, variations in management are frequent. The aim of this study was to identify practices and attitudes of Serbian physicians relating to the treatment of hypothyroidism. Methods. An anonymized questionnaire was distributed electronically to members of the Serbian Thyroid Society, Serbian Association of Endocrine Surgeons, and Section for Endocrinology of the Serbian Medical Society. Results. Out of 170 invitations, 99 responses were received. LT4 was the first choice for the treatment of hypothyroidism in 90% of patients. After starting LT4 replacement therapy most respondents would recheck thyroid-stimulating hormone (TSH) in 4–6 weeks (n = 51, 62%) and in eight weeks (n = 29, 35%). In total, 61% of respondents (n = 60) indicated that they would consider treating euthyroid patients with LT4, the commonest indication being female infertility with high levels of thyroid antibodies (54%, n = 50). More than half respondents (58%, n = 45) would recommend combined LT4 + LT3 therapy for patients on LT4 with normal serum TSH who still complain of symptoms of hypothyroidism. 53% (n = 41/77), reported that the frequency of patients with normal serum TSH who still complain of hypothyroid symptoms is less than 5%. Conclusion. LT4 was the first choice of therapy for the treatment of hypothyroid patients, whereas LT3 + LT4 combination treatment is considered in patients with persistent symptoms of hypothyroidism despite normalization of TSH. The most common indication for thyroid hormone treatment in euthyroid patients was female infertility with high levels of thyroid antibodies. Alternative LT4 formulations like liquid solution or soft-gel capsules –formulations presently not available in Serbia, were largely reserved for specific conditions (interfering drugs, malabsorption, inability to take LT4 in the fasting state, unexplained poor biochemical control of hypothyroidism).http://www.doiserbia.nb.rs/img/doi/0370-8179/2022/0370-81792200110N.pdfthesissurveyserbiathyroid hormoneshypothyroidismlevothyroxine
spellingShingle Nedeljković-Beleslin Biljana
Attanasio Roberto
Hegedüs Laszlo
Nagy Endre V.
Negro Roberto
Papini Enrico
Perros Petros
Ćirić Jasmina
Žarković Miloš
Use of thyroid hormones in hypothyroid and euthyroid patients: A THESIS questionnaire survey of Serbian physicians
Srpski Arhiv za Celokupno Lekarstvo
thesis
survey
serbia
thyroid hormones
hypothyroidism
levothyroxine
title Use of thyroid hormones in hypothyroid and euthyroid patients: A THESIS questionnaire survey of Serbian physicians
title_full Use of thyroid hormones in hypothyroid and euthyroid patients: A THESIS questionnaire survey of Serbian physicians
title_fullStr Use of thyroid hormones in hypothyroid and euthyroid patients: A THESIS questionnaire survey of Serbian physicians
title_full_unstemmed Use of thyroid hormones in hypothyroid and euthyroid patients: A THESIS questionnaire survey of Serbian physicians
title_short Use of thyroid hormones in hypothyroid and euthyroid patients: A THESIS questionnaire survey of Serbian physicians
title_sort use of thyroid hormones in hypothyroid and euthyroid patients a thesis questionnaire survey of serbian physicians
topic thesis
survey
serbia
thyroid hormones
hypothyroidism
levothyroxine
url http://www.doiserbia.nb.rs/img/doi/0370-8179/2022/0370-81792200110N.pdf
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