Heald, Adrian H, Premawardhana, Lakdasa, Taylor, Peter, Okosieme, Onyebuchi, Bangi, Tasneem, Devine, Holly, Livingston, Mark, Javed, Ahmed, Moreno, Gabriela YC, Watt, Torquil et al (show 3 more authors)
(2021)
Is there a role for natural desiccated thyroid in the treatment of levothyroxine unresponsive hypothyroidism? Results from a consecutive case series.
INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, 75 (12).
e14967-.
Abstract
<h4>Introduction</h4>Some levothyroxine unresponsive individuals with hypothyroidism are prescribed a natural desiccated thyroid (NDT) preparation such as Armour Thyroid<sup>®</sup> or ERFA Thyroid<sup>®</sup> . These contain a mixture of levothyroxine and liothyronine in a fixed ratio. We evaluated the response to NDT in individuals at a single endocrine centre in terms of how the change from levothyroxine to NDT impacted on their lives in relation to quality of life (QOL) and thyroid symptoms.<h4>Methods</h4>The ThyPRO39 (thyroid symptomatology) and EQ-5D-5L-related QoL/EQ5D5L (generic QOL) questionnaires were administered to 31 consecutive patients who had been initiated on NDT, before initiating treatment/6 months later.<h4>Results</h4>There were 28 women and 3 men. The dose range of NDT was 60-180 mg daily. Age range was 26-77 years with length of time since diagnosis with hypothyroidism ranging from 2 to 40 years. One person discontinued the NDT because of lack of response; two because of cardiac symptoms. EQ-5D-5L utility increased from a mean (SD) of 0.214 (0.338) at baseline, to 0.606 (0.248) after 6 months; corresponding to a difference of 0.392 (95% CI 0.241-0.542), t = 6.82, P < .001. EQ-VAS scores increased from 33.4 (17.2) to 71.1 (17.5), a difference of 37.7 (95% CI 25.2-50.2), t = -4.9, P < .001. ThyPRO scores showed consistent fall across all domains with the composite QoL-impact Score improving from 68.3 (95% CI 60.9-75.7) to 25.2 (95% CI 18.7-31.7), a difference of 43.1 (95% CI 33-53.2) (t = 5.6, P < .001).<h4>Conclusion</h4>Significant symptomatic benefit and improvement in QOL was experienced by people with a history of levothyroxine unresponsive hypothyroidism treated with NDT, suggesting the need for further evaluation of NDT in this context.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Humans, Hypothyroidism, Triiodothyronine, Thyroxine, Quality of Life, Adult, Aged, Middle Aged, Female, Male |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 06 Jun 2022 09:38 |
| Last Modified: | 18 Jan 2023 21:00 |
| DOI: | 10.1111/ijcp.14967 |
| Open Access URL: | https://doi.org/10.1111/ijcp.14967 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3155944 |
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