Use of thyroid hormone in hypothyroid and euthyroid patients. the THESIS questionnaire survey in spain

Use of thyroid hormones in hypothyroid and euthyroid patients: a 2020 THESIS questionnaire survey of members of the Hellenic Endocrine Society.

“…Our data demonstrate that in Greece LT4 is the first choice for the treatment of patients with hypothyroidism. This is in accordance with current guidelines [3] and with results from the Italian [20], Danish [21], Romanian [22], Polish [23], Bulgarian [24] and Spanish [25] THESIS investigation.…”

“…Interestingly, a rather large percentage of respondents would use selenium or iodine in patients with autoimmune thyroiditis (38.0%), subclinical hypothyroidism (6.1%) or if requested by the patient (20.6%). These results are in accordance with the Polish [23] THESIS investigation, while in other countries, such as Denmark [21] and Bulgaria [24], such supplementation was used less frequently. Current practice guidelines do not recommend the use of dietary supplements (including selenium and iodine) in the management of hypothyroidism, especially in iodinesufficient areas [3].…”

“…The above responses were not based on solid scientific evidence and deviate from current guidelines. While this is in accordance with the results of the Polish survey [23], the other national THESIS surveys reported lower percentages of use of thyroid hormones for euthyroid subjects with such symptoms [20,21,22,24,25]. Finally, in keeping with data from other European countries, only very few respondents considered the use of desiccated thyroid extract.…”

“…The reasons why the use of combination treatment is so widespread in our study and in those from other European countries, when the evidence for benefit is against it, is unclear, but may be related to the high prevalence of unexplained symptoms among hypothyroid patients and the recommendation by European guidelines that a trial of combination treatment may be offered in these circumstances [18]. The survey from Bulgaria [24] and Spain [25] reported lower, while the Danish study showed higher percentages [21]. Genetic polymorphisms in deiodinase or thyroid hormone transporter genes have been reported and are associated with variability in thyroid hormone concentrations [34].…”

“…Thyroid autoimmunity has been associated with infertility, especially in women with ovulatory dysfunction, but recent large prospective studies have not shown any benefit of LT4 treatment [28]. Despite this lack of evidence, the Greek data indicate that this is being practiced in real life and is in accordance with the findings of the other national THESIS surveys [20,21,22,23,24,25].…”