Levothyroxine (LT4) is a standard therapy in hypothyroidism; however, its bioavailability and therapeutic effects might be affected by many factors. Data shows that therapy with liquid LT4 characterized by quicker pharmacokinetics provides better thyroid hormones control than tablet LT4. We addressed the quality of life (QoL) and efficacy of the new ethanol-free formula of liquid LT4 (Tirosint®SOL) treatment in 76 euthyroid patients with primary (PH, n = 46) and central hypothyroidism (CH, n = 30), and compared the results to retrospective data on equivalent doses of tablet L-T4 therapy. After 8 weeks of liquid LT4 therapy, we found a significant improvement in QoL in both PH and CH patients. TSH levels were unaltered in PH patients. Free hormone levels (fT4 and fT3) increased in all the patients, with the exception of fT3 in the CH group. SHBG and low-density lipoprotein (LDL) also improved. Liquid LT4 therapy provided a better thyroid hormone profile and improvement in patients’ QoL than the tablet form, which was possibly due to the more favorable pharmacokinetics profile resulting in better absorption, as suggested by the increased free thyroid hormone levels. In summary, this is the first study addressing the QoL in hypothyroid patients, including primary and central hypothyroidism, treated with liquid LT4 formula in everyday practice.
Synthetic levothyroxine is the first line treatment for hypothyroidism, one of the most common endocrine disorders, independently its cause, in all age groups. The Polish Endocrinological Society, together with European Thyroid Association, American Thyroid Association and American Association of Clinical Endocrinologists, do not recommend the use of dried thyroid preparations, triiodothyronine or combined preparations of thyroxine with triiodothyronine. The objective of treatment is to achieve biochemical and clinical euthyroidism monitored by TSH and/or FT4 levels. The daily dose of levothyroxine depends on many factors, including the etiology and severity of hypothyroidism, age, body weight, pregnancy and comorbidities. Routinely, levothyroxine is administered on an empty stomach at least 30 minutes before breakfast (ATA 2014 recommend up to 60 minutes interval between meal and taking the drug). Levothyroxine can also be used in combination therapy in Graves’ disease. Currently, the routine use of synthetic sodium levothyroxine in patients with multinodular goiter is not recommended because it increases the risk of osteoporosis in postmenopausal women and atrial fibrillation in patients after 60 year of life.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.