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Clinical Thyroidology / Original Paper

Free Access

Treating Hypothyroidism with Thyroxine/Triiodothyronine Combination Therapy in Denmark: Following Guidelines or Following Trends?

Michaelsson L.F.a · Medici B.B.a · la Cour J.L.a, b · Selmer C.a · Røder M.c, d · Perrild H.e · Knudsen N.e · Faber J.a, f · Nygaard B.a

Author affiliations

aDepartment of Endocrinology, Herlev Hospital, University of Copenhagen, bDepartment of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, cDepartment of Medicine, Gentofte Hospital, University of Copenhagen, dDivision of Pharmacies and Reimbursement, Danish Health and Medicines Authority, eDepartment of Endocrinology, Bispebjerg Hospital, University of Copenhagen, and fFaculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

Corresponding Author

Luba Freja Michaelsson

Department of Endocrinology O

Herlev Hospital, University of Copenhagen

Herlev Ringvej 75, DK-2730 Copenhagen (Denmark)

E-Mail luba.freja.liubov.michaelsson@regionh.dk

Related Articles for ""

Eur Thyroid J 2015;4:174-180

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Abstract

Background: Five to ten percent of patients with hypothyroidism describe persistent symptoms despite being biochemically well regulated on levothyroxine (L-T4). Thyroxine (T4)/triiodothyronine (T3) combination therapy [L-T4/liothyronine (L-T3) or desiccated thyroid] are still regarded as experimental with no evidence of superior effect on persistent symptoms according to meta-analyses. However, some randomized controlled trials have demonstrated patients' preference for T4/T3 combination therapy as compared to L-T4 monotherapy. In 2013, attention to combination therapy increased in Denmark after a patient published a book describing her experiences with hypothyroidism and treatment. Objective: To investigate current Danish trends in the use of T4/T3 combination therapy. Methods: We used an Internet-based questionnaire, distributed as a link via two Danish patient fora. Further, information was obtained from the Division of Pharmacies and Reimbursement at the Danish Health and Medicines Authority and from the only pharmacy in Denmark producing desiccated thyroid and L-T3 tablets. Results: A total of 384 patients answered the questionnaire, and 293 responders were included. Sixty-nine percent of the responders had six or more symptoms, and 84% reported a treatment effect. Forty-four percent of the responders received their prescriptions from general practitioners; 50% received desiccated thyroid and 28% reported that they adjust their dose themselves. Responders followed by general practitioners more frequently received desiccated thyroid and adjusted their dose themselves. Conclusions: Increased media focus has changed the prescription pattern of thyroid hormones; European guidelines on T4/T3 combination therapy are not always followed in Denmark and many patients adjust their medication themselves and may therefore be at risk of overtreatment.

© 2015 European Thyroid Association Published by S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Clinical Thyroidology / Original Paper

Received: May 08, 2015
Accepted: June 26, 2015
Published online: August 14, 2015
Issue release date: September 2015

Number of Print Pages: 7
Number of Figures: 2
Number of Tables: 4

ISSN: 2235-0640 (Print)
eISSN: 2235-0802 (Online)

For additional information: http://www.karger.com/ETJ


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