Exercise is associated with better quality of life in patients on TSH-suppressive therapy with levothyroxine for differentiated thyroid carcinoma

Vigário, Patrícia dos Santos; Chachamovitz, Dhiãnah Santini de Oliveira; Teixeira, Patrícia de Fátima dos Santos; Rocque, Maíra de La; Santos, Maryna Lobo dos

doi:10.1590/0004-2730000002968

Cited by 22 publications

(19 citation statements)

References 27 publications

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“…In patients with hypothyroidism due to treatment of thyroid cancer, fatigue seems to be associated with decreased physical activity [112]. Physical activity also partially alleviates the fatigue in patients with thyroid cancer [113, 114]. Given these considerations, it might be reasonable to consider a trial of standard of care LT4 versus LT4 and lifestyle changes, including exercise.…”

Section: Results: Topics Summaries Summary Statements and Consensusmentioning

confidence: 99%

Evidence-Based Use of Levothyroxine/Liothyronine Combinations in Treating Hypothyroidism: A Consensus Document

et al. 2021

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Background: Fourteen clinical trials have not shown a consistent benefit of combination therapy with levothyroxine (LT4) and liothyronine (LT3). Despite the publication of these trials, combination therapy is widely used and patients reporting benefit continue to generate patient and physician interest in this area. Recent scientific developments may provide insight into this inconsistency and guide future studies. Methods: The American Thyroid Association (ATA), British Thyroid Association (BTA), and European Thyroid Association (ETA) held a joint conference on November 3, 2019 (live-streamed between Chicago and London) to review new basic science and clinical evidence regarding combination therapy with presentations and input from 12 content experts. After the presentations, the material was synthesized and used to develop Summary Statements of the current state of knowledge. After review and revision of the material and Summary Statements, there was agreement that there was equipoise for a new clinical trial of combination therapy. Consensus Statements encapsulating the implications of the material discussed with respect to the design of future clinical trials of LT4/LT3 combination therapy were generated. Authors voted upon the Consensus Statements. Iterative changes were made in several rounds of voting and after comments from ATA/BTA/ETA members. Results: Of 34 Consensus Statements available for voting, 28 received at least 75% agreement, with 13 receiving 100% agreement. Those with 100% agreement included studies being powered to study the effect of deiodinase and thyroid hormone transporter polymorphisms on study outcomes, inclusion of patients dissatisfied with their current therapy and requiring at least 1.2 µg/kg of LT4 daily, use of twice daily LT3 or preferably a slow-release preparation if available, use of patient-reported outcomes as a primary outcome (measured by a tool with both relevant content validity and responsiveness) and patient preference as a secondary outcome, and utilization of a randomized placebo-controlled adequately powered double-blinded parallel design. The remaining statements are presented as potential additional considerations. Discussion: This article summarizes the areas discussed and presents Consensus Statements to guide development of future clinical trials of LT4/LT3 combination therapy. The results of such redesigned trials are expected to be of benefit to patients and of value to inform future thyroid hormone replacement clinical practice guidelines treatment recommendations.

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Section: Results: Topics Summaries Summary Statements and Consensusmentioning

confidence: 99%

Evidence-Based Use of Levothyroxine/Liothyronine Combinations in Treating Hypothyroidism: A Consensus Document

et al. 2021

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“…Current guidelines for the management of hypothyroidism recommend that LT4 remains the first-line treatment. Exercise appears to be an effective way of combating fatigue and improving the quality of life in this setting [21,23]. A similar benefit was observed in LT4-treated breast cancer patients undergoing chemotherapy [24].…”

Section: Patient-reported Outcomesmentioning

confidence: 76%

Levothyroxine and Cancer

Bednarczuk

2021

70 Years of Levothyroxine

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Treatment with LT4 is used to suppress thyrotropin levels after the management of differentiated thyroid cancers after surgery, with doses and targets for thyrotropin (thyroid-stimulating hormone, TSH) determined by the risk of cancer recurrence determined in the individual patient. Moreover, the role of thyroid hormones and their receptors in the initiation-and, potentially, cure-of a range of cancer types is an active area of research.

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“…Exercise seems to play an important role in DTC patients and to minimize the treatment effect on quality of life, said Patricia dos Santos Vigario et al [5] in a study published in 2013. The exercise program consisted of 60 minutes of aerobic and stretching exercises, twice a week during twelve weeks.…”

Section: Resultsmentioning

confidence: 99%

Quality of life in thyroid cancer patients: a literature review

Bărbuş

Peștean

Larg

et al. 2017

Medicine and Pharmacy Reports

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IntroductionQuality of life (QoL) has received increasing interest in the last years, especially in patients with cancer. This article aims to analyze a selection of medical research papers regarding the quality of life in patients with thyroid carcinoma. We overviewed the main QoL aspects derived from several studies and highlighted those less researched issues, which could represent a solid base for future clinical studies.MethodWe used an integrative selection method of medical literature, choosing mostly “free access” studies, as it was considered that they could be easily viewed, searched and researched including by patients.ResultsAfter an integrative literature review, we selected 16 relevant studies. Patients with thyroid cancer have several factors influencing their QoL, with both physical and psychological impact. The decisive factors are the quality of the surgical act, radioiodine therapy, follow-up using rh-TSH vs. hormonal withdrawal, access to behavioral help and the relationship with their physician.ConclusionWe must understand the emotional impact of the cancer diagnosis on the patient and we must collaborate in order to help the patient restore the psychosomatic balance and to recover the quality of life

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Exercise is associated with better quality of life in patients on TSH-suppressive therapy with levothyroxine for differentiated thyroid carcinoma

Cited by 22 publications

References 27 publications

Evidence-Based Use of Levothyroxine/Liothyronine Combinations in Treating Hypothyroidism: A Consensus Document

Evidence-Based Use of Levothyroxine/Liothyronine Combinations in Treating Hypothyroidism: A Consensus Document

Levothyroxine and Cancer

Quality of life in thyroid cancer patients: a literature review

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