T3 therapy in hypothyroidism. Still more questions than answers

Concepción-Zavaleta, Marcio José; Arroyo, Julia; Zavaleta-Gutiérrez, Francisca Elena; Concepción-Urteaga, Luis Alberto

doi:10.20945/2359-3997000000378

Cited by 2 publications

(1 citation statement)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…If a trial of combination therapy is being considered in an individual patient, it is important to set clear expectations [39]. These include explaining that this is a non-standard treatment for which the risks remain unclear, with the potential risk of accelerated osteoporosis, atrial fibrillation, and stroke.…”

Section: Candidates For Combined Levothyroxine + Liothyronine Therapymentioning

confidence: 99%

Liothyronine use in primary hypothyroidism — current concepts

Concepción-Zavaleta¹,

Ildefonso-Najarro

Paz-Ibarra

et al. 2021

Endokrynologia Polska

View full text Add to dashboard Cite

Hypothyroidism is an endocrine disorder whose management raises many challenges in clinical practice. Its standard treatment is levothyroxine (LT4). The goal of the treatment is to normalize signs and symptoms, as well as to achieve thyroid-stimulating hormone (TSH) concentrations within the reference range, on an individual basis. It is known that 5-10% of hypothyroid patients remain symptomatic, despite achieving the target TSH levels, which, in turn, affects their quality of life. After ruling out other causes of non-thyroid origin for this persistence, it is suggested that these patients could benefit from the use of liothyronine (LT3), added to LT4, especially if polymorphism of the deiodinase 2 (D2) genes is documented. There exist a variety of LT3 preparations, whose concentrations vary from 5 to 50 ug, with the recommended LT4/LT3 ratio of 13:1-20:1. The goals of combination therapy should be to achieve a physiological ratio of free triiodothyronine/free thyroxine (FT3/FT4) and non-suppression of TSH. Because there is currently no guide that makes evidence-based recommendations on the use of LT3 in primary hypothyroidism, more clinical studies are needed to be able to identify hypothyroid patients who may benefit from the use of LT3, by identifying new biomarkers.

show abstract

Section: Candidates For Combined Levothyroxine + Liothyronine Therapymentioning

confidence: 99%