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Clinical Thyroidology / Original Paper

Hypothyroid Patients Encoding Combined MCT10 and DIO2 Gene Polymorphisms May Prefer L-T3 + L-T4 Combination Treatment – Data Using a Blind, Randomized, Clinical Study

Carlé A.a · Faber J.c,d · Steffensen R.b · Laurberg P.a · Nygaard B.c,d

Author affiliations

aDepartment of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
bDepartment of Clinical Immunology, Aalborg University Hospital, Aalborg, Denmark
cDepartment of Endocrinology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
dFaculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

Related Articles for ""

Eur Thyroid J 2017;6:143–151

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Article / Publication Details

First-Page Preview
Abstract of Clinical Thyroidology / Original Paper

Received: December 05, 2016
Accepted: March 07, 2017
Published online: April 24, 2017
Issue release date: June 2017

Number of Print Pages: 9
Number of Figures: 2
Number of Tables: 2

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

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

Abstract

Objectives: In previous studies, around half of all hypothyroid patients preferred levo-thyroxine (L-T4) + levo-triiodothyronine (L-T3) combination therapy, 25% preferred T4, and 25% had no preference. The reason for this is yet to be explored. Methods: A total of 45 overtly autoimmune, hypothyroid patients – now euthyroid on ≥6 months’ L-T4 therapy – participated in a prospective, double-blind, cross-over study. The patients were randomized into 2 groups of either 3 continuous months’ L-T4 therapy followed by 3 months’ combination therapy or vice versa. In all periods, 50 μg L-T4 was blindly replaced by either (identical) 50 μg L-T4 or by 20 μg T3. L-T4 was hereafter adjusted to obtain normal serum TSH values. We investigated 3 single nucleotide polymorphisms (SNPs) on the type II iodothyronine deiodinase (DIO2) gene (rs225014 (Thr92Ala), rs225015, and rs12885300 (ORFa-Gly3Asp)) and 1 SNP on the cellular membrane transport-facilitating monocarboxylate transporter (MCT10) gene (rs17606253), and asked in which of the 2 treatment periods patients felt better (i.e., which treatment was preferred). Results: 27 out of 45 patients (60%) preferred the combination therapy. Two polymorphisms (rs225014 (DIO2, Thr92Ala) and rs17606253 (MCT10)) were combined yielding 3 groups: none vs. 1 of 2 vs. both SNPs present, and 42 vs. 63 vs. 100% of our patients in the 3 groups preferred the combined treatment (Jongheere-Terpstra trend test, p = 0.009). Conclusion: The present study indicates that the combination of polymorphisms in DIO2 (rs225014) and MCT10 (rs17606253) enhances hypothyroid patients’ preference for L-T4 + L-T3 replacement therapy. In the future, combination therapy may be restricted or may be even recommended to individuals harbouring certain polymorphisms.

© 2017 European Thyroid Association. Published by S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Clinical Thyroidology / Original Paper

Received: December 05, 2016
Accepted: March 07, 2017
Published online: April 24, 2017
Issue release date: June 2017

Number of Print Pages: 9
Number of Figures: 2
Number of Tables: 2

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

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


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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