The use of L-thyroxine in the treatment of thyroid pathologies and problems of therapy control (literature review)
Background. Thyroid disease is one of the most common pathologies in the world, wich includs hypothyroidism, hyperthyroidism and thyroid cancer. At the present, there is an increase in their cases. The thyroid gland is an extremely important for the health of a person, thyroid hormones are necessary...
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| Format: | Article |
| Language: | English |
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National Academy of Medical Sciences of Ukraine. Grigoriev Institute for Medical Radiology and Oncology
2020-12-01
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| Series: | Український радіологічний та онкологічний журнал |
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| Online Access: | https://ukroj.com/index.php/journal/article/view/57 |
| _version_ | 1823930604938330112 |
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| author | Н. С. Підченко |
| author_facet | Н. С. Підченко |
| author_sort | Н. С. Підченко |
| collection | DOAJ |
| description | Background. Thyroid disease is one of the most common pathologies in the world, wich includs hypothyroidism, hyperthyroidism and thyroid cancer. At the present, there is an increase in their cases. The thyroid gland is an extremely important for the health of a person, thyroid hormones are necessary for the normal functioning of all tissues in the body.
Purpose. To structure and summarize scientific findings on the role of thyroid hormones (T4, T3 and rT3) in the development of hypothyroidism, their effect on inhibiting the growth of cancer cells and the cytotoxic effects of these hormones on thyroid cells.
Results and discussion. In spite of a careful study of thyroid function, the use of thyroid hormones and laboratory monitoring in the treatment of various thyroid pathologies remains debatable up to now. In particular, it concerns LT4 + LT3 combination and the role of reversible T3. This is due to a complex regulation system depending on many factors: hormonal homeostasis, nutritional factors, physiological conditions, etc., which together maintain appropriate thyroid functioning. LT4 monotherapy remains the standard method of replacement therapy, however, according to the ETA recommendations, it is possible for individual patients to prescribe combination therapy LT4 + LT3 as an experimental approach. The use of the rT3 test as a prognostic / diagnostic indicator for monitoring the therapy of patients receiving L-thyroxine therapy is discussed. The use of L-thyroxine as a thyrotropic suppressive therapy in the treatment of thyroid cancer requires careful dose adjustment depending on the health status of each patient, the risk of recurrence, which requires monitoring and dynamic reassessment. Long-term suppressive therapy of LT4 can affect metabolism, contributing to weight loss.
Conclusions. Given the analysis of the literature, which covered 20 years, today L-T4 monotherapy is the standard therapy for patients with hypothyroidism. LT4 + LT3 combination therapy can be recommended in patients receiving L-T4 treatment with complaints characteristic of hypothyroidism despite normal TSH levels, with the exception of other chronic and concomitant autoimmune diseases that may be the cause. |
| first_indexed | 2024-12-16T21:26:53Z |
| format | Article |
| id | doaj.art-7ee9c78c27494200afb3c6aae876ca60 |
| institution | Directory Open Access Journal |
| issn | 2708-7166 2708-7174 |
| language | English |
| last_indexed | 2024-12-16T21:26:53Z |
| publishDate | 2020-12-01 |
| publisher | National Academy of Medical Sciences of Ukraine. Grigoriev Institute for Medical Radiology and Oncology |
| record_format | Article |
| series | Український радіологічний та онкологічний журнал |
| spelling | doaj.art-7ee9c78c27494200afb3c6aae876ca602022-12-21T22:15:42ZengNational Academy of Medical Sciences of Ukraine. Grigoriev Institute for Medical Radiology and OncologyУкраїнський радіологічний та онкологічний журнал2708-71662708-71742020-12-0128438740210.46879/ukroj.4.2020.387-40257The use of L-thyroxine in the treatment of thyroid pathologies and problems of therapy control (literature review)Н. С. Підченко0State Organization «Grigoriev Institute for Medical Radiology and Oncology of the National Academy of Medical Sciences of Ukraine», Kharkiv, UkraineBackground. Thyroid disease is one of the most common pathologies in the world, wich includs hypothyroidism, hyperthyroidism and thyroid cancer. At the present, there is an increase in their cases. The thyroid gland is an extremely important for the health of a person, thyroid hormones are necessary for the normal functioning of all tissues in the body. Purpose. To structure and summarize scientific findings on the role of thyroid hormones (T4, T3 and rT3) in the development of hypothyroidism, their effect on inhibiting the growth of cancer cells and the cytotoxic effects of these hormones on thyroid cells. Results and discussion. In spite of a careful study of thyroid function, the use of thyroid hormones and laboratory monitoring in the treatment of various thyroid pathologies remains debatable up to now. In particular, it concerns LT4 + LT3 combination and the role of reversible T3. This is due to a complex regulation system depending on many factors: hormonal homeostasis, nutritional factors, physiological conditions, etc., which together maintain appropriate thyroid functioning. LT4 monotherapy remains the standard method of replacement therapy, however, according to the ETA recommendations, it is possible for individual patients to prescribe combination therapy LT4 + LT3 as an experimental approach. The use of the rT3 test as a prognostic / diagnostic indicator for monitoring the therapy of patients receiving L-thyroxine therapy is discussed. The use of L-thyroxine as a thyrotropic suppressive therapy in the treatment of thyroid cancer requires careful dose adjustment depending on the health status of each patient, the risk of recurrence, which requires monitoring and dynamic reassessment. Long-term suppressive therapy of LT4 can affect metabolism, contributing to weight loss. Conclusions. Given the analysis of the literature, which covered 20 years, today L-T4 monotherapy is the standard therapy for patients with hypothyroidism. LT4 + LT3 combination therapy can be recommended in patients receiving L-T4 treatment with complaints characteristic of hypothyroidism despite normal TSH levels, with the exception of other chronic and concomitant autoimmune diseases that may be the cause.https://ukroj.com/index.php/journal/article/view/57thyroid gland, thyroid cancer, thyroid hormones, thyroxine, triiodothyronine, reversible triiodothyronine, l-thyroxine. |
| spellingShingle | Н. С. Підченко The use of L-thyroxine in the treatment of thyroid pathologies and problems of therapy control (literature review) Український радіологічний та онкологічний журнал thyroid gland, thyroid cancer, thyroid hormones, thyroxine, triiodothyronine, reversible triiodothyronine, l-thyroxine. |
| title | The use of L-thyroxine in the treatment of thyroid pathologies and problems of therapy control (literature review) |
| title_full | The use of L-thyroxine in the treatment of thyroid pathologies and problems of therapy control (literature review) |
| title_fullStr | The use of L-thyroxine in the treatment of thyroid pathologies and problems of therapy control (literature review) |
| title_full_unstemmed | The use of L-thyroxine in the treatment of thyroid pathologies and problems of therapy control (literature review) |
| title_short | The use of L-thyroxine in the treatment of thyroid pathologies and problems of therapy control (literature review) |
| title_sort | use of l thyroxine in the treatment of thyroid pathologies and problems of therapy control literature review |
| topic | thyroid gland, thyroid cancer, thyroid hormones, thyroxine, triiodothyronine, reversible triiodothyronine, l-thyroxine. |
| url | https://ukroj.com/index.php/journal/article/view/57 |
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