Use of thyroid hormones in hypothyroid and euthyroid patients: a THESIS* survey of Belgian specialists *THESIS: treatment of hypothyroidism in Europe by specialists: an international survey.
Hypothyroidism; Survey; Thyroid hormones; Endocrine and Autonomic Systems; Endocrinology; Endocrinology, Diabetes and Metabolism
Abstract :
[en] BACKGROUND: Hypothyroidism is a topic that continues to provoke debate and controversy with regards to specific indications, type of thyroid hormone substitution and efficacy. We investigated the use of thyroid hormones in clinical practice in Belgium, a country where currently only levothyroxine (LT4) tablet formulations are available.
METHOD: Members of the Belgian Endocrine Society were invited to respond to an online questionnaire. Results were compared with those from other THESIS surveys.
RESULTS: Eighty (50%) of the invited 160 individuals, completed the questionnaire. LT4 was the first treatment of choice for all respondents. As secondary choice, some also prescribed liothyronine (LT3) and LT4 + LT3 combinations (2 and 7 respondents, respectively). Besides hypothyroidism, 34 and 50% of respondents used thyroid hormones for infertile euthyroid TPOAb positive women and the treatment of a growing non-toxic goiter, respectively. Had alternative formulations of LT4 to tablets been available (soft gel or liquid L-T4), 2 out of 80 (2.5%) participants would consider them for patients achieving biochemical euthyroidism but remaining symptomatic. This proportion was higher in case of unexplained poor biochemical control of hypothyroidism (13.5%) and in patients with celiac disease or malabsorption or interfering drugs (10%). In symptomatic euthyroid patients, 20% of respondents would try combined LT4 + LT3 treatment. Psychosocial factors were highlighted as the main contributors to persistent symptoms.
CONCLUSIONS: LT4 tablets is the preferred treatment for hypothyroidism in Belgium. A minority of the respondents would try combined LT4 + LT3 in symptomatic but biochemically euthyroid patients. Thyroid hormones are prescribed for euthyroid infertile women with thyroid autoimmunity and patients with non-toxic goiter, a tendency noted in other European countries, despite current evidence of lack of benefit.
Disciplines :
Endocrinology, metabolism & nutrition
Author, co-author :
Burlacu, Maria-Cristina; Department of Endocrinology and Nutrition, Cliniques Universitaires St-Luc, Université Catholique de Louvain, 1200, Brussels, Belgium. maria.burlacu@saintluc.uclouvain.be
Attanasio, Roberto; IRCCS Orthopedic Institute Galeazzi, Endocrine Unit, 20161, Milan, Italy
Hegedüs, Laszlo; Department of Endocrinology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
Nagy, Endre V; Division of Endocrinology, Department of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
Papini, Enrico; Department of Endocrinology and Metabolism, Regina Apostolorum Hospital, Albano, Rome, Italy
Perros, Petros; Department of Endocrinology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
Sawadogo, Kiswendsida; Statistical support unit, Institut Roi Albert II, Cliniques universitaires Saint-Luc, Brussels, Belgium
Bex, Marie; Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
Corvilain, Bernard; Department of Endocrinology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
Daumerie, Chantal; Department of Endocrinology and Nutrition, Cliniques Universitaires St-Luc, Université Catholique de Louvain, 1200, Brussels, Belgium
Decallonne, Brigitte; Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
Gruson, Damien; Department of Clinical Biochemistry, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
Lapauw, Bruno; Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
Reyes, Rodrigo Moreno; Department of Nuclear Medecine, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
PETROSSIANS, Patrick ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'endocrinologie clinique
Poppe, Kris; Endocrine Unit, CHU Saint- Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium
Van den Bruel, Annick; Department of Endocrinology, AZ Sint Jan Brugge Oostende AV, Brugge, Belgium
Unuane, David; Department of Internal Medicine, Endocrine Unit, UZ Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
Use of thyroid hormones in hypothyroid and euthyroid patients: a THESIS* survey of Belgian specialists *THESIS: treatment of hypothyroidism in Europe by specialists: an international survey.
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