Use of thyroid hormones in hypothyroid and euthyroid patients: a 2022 THESIS questionnaire survey of members of the Latin American Thyroid Society (LATS)
Abstract Purpose Inconsistencies in the medical management of hypothyroidism have been reported between endocrinologists in different countries. This study aimed to identify the attitudes of Latin America thyroid specialists towards the use of thyroid hormones. Methods Online survey of members of th...
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | Thyroid Research |
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| Online Access: | https://doi.org/10.1186/s13044-023-00182-4 |
| _version_ | 1827724202600300544 |
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| author | Jessica F. Cassemiro Veronica Ilera Stella Batalles Adriana Reyes Endre V. Nagy Enrico Papini Petros Perros Laszlo Hegedüs Helton Estrela Ramos |
| author_facet | Jessica F. Cassemiro Veronica Ilera Stella Batalles Adriana Reyes Endre V. Nagy Enrico Papini Petros Perros Laszlo Hegedüs Helton Estrela Ramos |
| author_sort | Jessica F. Cassemiro |
| collection | DOAJ |
| description | Abstract Purpose Inconsistencies in the medical management of hypothyroidism have been reported between endocrinologists in different countries. This study aimed to identify the attitudes of Latin America thyroid specialists towards the use of thyroid hormones. Methods Online survey of members of the Latin America Thyroid Society. Results 81/446 (18.2%) completed the questionnaire. Levothyroxine (LT4) was the initial treatment of choice for all respondents. 56.8% would consider LT4 use in biochemically euthyroid patients: infertile women with elevated anti-thyroid antibodies (46.9%), resistant depression (17.3%) and growing goiter (12%). Most respondents preferred tablets (39.5%) over liquid formulations (21.0%) or soft gel capsules (22.2%) and would not consider switching formulations in patients with persistent symptoms. 39.5% would never use LT4 + liothyronine (LT3) combination therapy in symptomatic euthyroid patients, due to low quality evidence for benefit. 60.5% reported that persistence of symptoms despite normal TSH is rare (below 5% of patients) and its prevalence has been stable over the last five years. Psychosocial factors (84.0%), comorbidities (86.4%) and the patient unrealistic expectation (72.8%) were considered the top three explanations for this phenomenon. Conclusion LT4 tablets is the treatment of choice for hypothyroidism. A significant proportion of respondents would use LT4 in some groups of euthyroid individuals, contrasting the recommendations of the major clinical practice guideline indications. LT4 + LT3 combination treatment in euthyroid symptomatic patients was considered by nearly 50%. Practices based on weak or absent evidence included use of thyroid hormones for euthyroid subjects by 56.8% of respondents and use of LT4 + LT3 treatment by 60.5% of respondents for patients with persistent symptoms. In contrast to many European countries, LATS respondents report a low and unchanged proportion of dissatisfied patients over the last five years. |
| first_indexed | 2024-03-10T22:12:23Z |
| format | Article |
| id | doaj.art-73a00f5b09ed4dfc8e7631d9e9f8aab0 |
| institution | Directory Open Access Journal |
| issn | 1756-6614 |
| language | English |
| last_indexed | 2024-03-10T22:12:23Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Thyroid Research |
| spelling | doaj.art-73a00f5b09ed4dfc8e7631d9e9f8aab02023-11-19T12:34:35ZengBMCThyroid Research1756-66142023-09-011611910.1186/s13044-023-00182-4Use of thyroid hormones in hypothyroid and euthyroid patients: a 2022 THESIS questionnaire survey of members of the Latin American Thyroid Society (LATS)Jessica F. Cassemiro0Veronica Ilera1Stella Batalles2Adriana Reyes3Endre V. Nagy4Enrico Papini5Petros Perros6Laszlo Hegedüs7Helton Estrela Ramos8Department of Bioregulation, Health & Science Institute, Federal University of BahiaDepartment of Endocrinology, Hospital Ramos MejíaCardiovascular Institute of RosarioDepartment of Endocrinology, Hospital Ramos MejíaDivision of Endocrinology, Department of Medicine, Faculty of Medicine, University of DebrecenDepartment of Endocrinology and Metabolism, Regina Apostolorum HospitalDepartment of Endocrinology, Royal Victoria InfirmaryDepartment of Endocrinology, Odense University HospitalDepartment of Bioregulation, Health & Science Institute, Federal University of BahiaAbstract Purpose Inconsistencies in the medical management of hypothyroidism have been reported between endocrinologists in different countries. This study aimed to identify the attitudes of Latin America thyroid specialists towards the use of thyroid hormones. Methods Online survey of members of the Latin America Thyroid Society. Results 81/446 (18.2%) completed the questionnaire. Levothyroxine (LT4) was the initial treatment of choice for all respondents. 56.8% would consider LT4 use in biochemically euthyroid patients: infertile women with elevated anti-thyroid antibodies (46.9%), resistant depression (17.3%) and growing goiter (12%). Most respondents preferred tablets (39.5%) over liquid formulations (21.0%) or soft gel capsules (22.2%) and would not consider switching formulations in patients with persistent symptoms. 39.5% would never use LT4 + liothyronine (LT3) combination therapy in symptomatic euthyroid patients, due to low quality evidence for benefit. 60.5% reported that persistence of symptoms despite normal TSH is rare (below 5% of patients) and its prevalence has been stable over the last five years. Psychosocial factors (84.0%), comorbidities (86.4%) and the patient unrealistic expectation (72.8%) were considered the top three explanations for this phenomenon. Conclusion LT4 tablets is the treatment of choice for hypothyroidism. A significant proportion of respondents would use LT4 in some groups of euthyroid individuals, contrasting the recommendations of the major clinical practice guideline indications. LT4 + LT3 combination treatment in euthyroid symptomatic patients was considered by nearly 50%. Practices based on weak or absent evidence included use of thyroid hormones for euthyroid subjects by 56.8% of respondents and use of LT4 + LT3 treatment by 60.5% of respondents for patients with persistent symptoms. In contrast to many European countries, LATS respondents report a low and unchanged proportion of dissatisfied patients over the last five years.https://doi.org/10.1186/s13044-023-00182-4LevothyroxineLiothyronineHypothyroidismEuthyroidismSurveyLatin American Thyroid Society |
| spellingShingle | Jessica F. Cassemiro Veronica Ilera Stella Batalles Adriana Reyes Endre V. Nagy Enrico Papini Petros Perros Laszlo Hegedüs Helton Estrela Ramos Use of thyroid hormones in hypothyroid and euthyroid patients: a 2022 THESIS questionnaire survey of members of the Latin American Thyroid Society (LATS) Thyroid Research Levothyroxine Liothyronine Hypothyroidism Euthyroidism Survey Latin American Thyroid Society |
| title | Use of thyroid hormones in hypothyroid and euthyroid patients: a 2022 THESIS questionnaire survey of members of the Latin American Thyroid Society (LATS) |
| title_full | Use of thyroid hormones in hypothyroid and euthyroid patients: a 2022 THESIS questionnaire survey of members of the Latin American Thyroid Society (LATS) |
| title_fullStr | Use of thyroid hormones in hypothyroid and euthyroid patients: a 2022 THESIS questionnaire survey of members of the Latin American Thyroid Society (LATS) |
| title_full_unstemmed | Use of thyroid hormones in hypothyroid and euthyroid patients: a 2022 THESIS questionnaire survey of members of the Latin American Thyroid Society (LATS) |
| title_short | Use of thyroid hormones in hypothyroid and euthyroid patients: a 2022 THESIS questionnaire survey of members of the Latin American Thyroid Society (LATS) |
| title_sort | use of thyroid hormones in hypothyroid and euthyroid patients a 2022 thesis questionnaire survey of members of the latin american thyroid society lats |
| topic | Levothyroxine Liothyronine Hypothyroidism Euthyroidism Survey Latin American Thyroid Society |
| url | https://doi.org/10.1186/s13044-023-00182-4 |
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