Thyroid hormone replacement therapy in patients with hypothyroidism: Understanding patient outcomes

Additionally, TSH goal achievers incurred significantly lower average medical and total all-cause and hypothyroidism-related costs than non-achievers. To our knowledge, this is the first real-world study looking into outcomes for goal achievers vs. non-achievers. Some studies suggest that generic levothyroxine, the synthetic form of the thyroid hormone thyroxine (T4), is non-inferior to Synthroid in treating mild hypothyroidism. Others have found that switching from Synthroid to a generic may make it harder vertigo synthroid to maintain tight control of your thyroid hormone levels.

And to adjust the dose based on periodic assessment of the patient’s clinical response and their laboratory values. The second is that Synthroid has a history, as physicians have been treating patients with hypothyroidism with Synthroid for over 65 years. So, as a reminder, SYNTHROID is indicated for the treatment of hypothyroidism. That is primary, secondary, or tertiary hypothyroidism, either due to congenital or acquired state. It is not indicated for the suppression of benign thyroid nodules, or for non-toxic defuse goiter in iodine-sufficient patients.

Data Availability

With the T3, it ranged in between 1.3 and 32 μg, which is more than the body probably makes in an average person. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Synthroid can be given to infants and children who cannot swallow whole tablets by crushing the tablet and mixing the freshly crushed tablet in a small amount (5 to 10 mL or 1 to 2 teaspoonfuls) of water and immediately giving the misture by spoon or dropper. Do not store the crushed tablet/water mixture and do not administer it mixed with foods that decrease absorption of levothyroxine, such as soybean-based infant formula.

Thyroid Supplements: Popularity and Controversy

• Armour Thyroid is used for hashimoto’s disease, hypothyroidism, after thyroid removal, thyroid …
• It can lead to clots, thromboses, strokes, and all sorts of things.
• Lastly, three studies reported significantly worse QoL in LT4-treated patients with overt hypothyroidism, relative to control patients with other diseases and to general population samples (66,73,86.
• Also, the patients in this subcohort may have multiple TSH values due to titration efforts, which our study did not further explore.
• However, the large double-blind, placebo-controlled RCTs in SCH (like IEMO and TRUST) assessed populations of elderly adults 65,100.

You can’t be born without T3 because it’s essential to developing in your mother’s belly. Some people make a little less and that gets into if you have hypothyroidism, maybe you do better on that combo T4/T3. Again, if you have hypothyroidism or a thyroid condition, you need an actual treatment for that and not supplements, because they’re not going to work in any reliable fashion whatsoever. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using. Levoxyl treats hypothyroidism (low thyroid hormone) and treats or prevents goiter.

That’s because substitutions can be made at the pharmacy if the prescription is not properly protected with the Dispense as Written (DAW) state-specific language. A levothyroxine product that is not therapeutically equivalent with SYNTHROID might not have the exact same effect on the patient’s TSH as SYNTHROID. I go over with them the fact that they should check the label at the pharmacy, on the bottle, to make sure it says brand-name SYNTHROID and not generic levothyroxine. And in many cases, to also pop the top off the bottle while they are at the pharmacy counter and look at the pills and make sure they have SYNTHROID embossed on those tablets. In a subpopulation with at least 2 TSH values recorded over 12months follow-up, we found directionally consistent results that were not statistically significant. In this analysis, the sample size was considerably reduced (containing only 21% of the base case cohort), which may contribute to statistical uncertainty.

• Many thyroid specialists aren’t very fond of it because you get weird thyroid function tests.
• Compared with patients who received GL, significantly fewer patients in the Synthroid treatment group had TSH levels outside the recommended range (0.3 to 4.12 mIU/L) and a smaller proportion was undertreated 9, 10.
• Research has been done, we have clinical experience, and there’s oversight on those products, and we talk about the options.
• Secondary outcomes were measured in a subset of matched patients from the primary objective with complete pharmacy cost capture.
• In this condition, the thyroid gland is not producing enough thyroid hormone.

Levothyroxine (LT4) monotherapy is considered the standard of care for the treatment of hypothyroidism 6, with Synthroid® (levothyroxine sodium tablets, AbbVie) and any one of multiple generic levothyroxine (GL) formulations most often prescribed in the US. Levothyroxine has a narrow therapeutic window, and slight variations in dose or differences in bioavailability between products can impact clinical effectiveness 8–10. Previous real-world research using administrative claims data demonstrated differences in outcomes between patients with hypothyroidism treated with Synthroid or GL 9, 10. Compared with patients who received GL, significantly fewer patients in the Synthroid treatment group had TSH levels outside the recommended range (0.3 to 4.12 mIU/L) and a smaller proportion was undertreated 9, 10.

Most studies of combination therapy did not evidence a difference in QoL for LT4 + LT3 combination therapy, relative to LT4 alone 25,47,48,50,51,60. When benefits were found, they concerned some but not all QoL domains 56,82,83. The majority subjective patient preference for LT4 + LT3 combination therapy (typically expressed by ~50–70% of the treated patients 50,51,56) cannot be explained by the QoL data per se. As discussed below, we hypothesize that today’s QoL instruments do not necessarily capture subtle changes (e.g., in mood) related to patient preference and wellbeing. Lastly, the presence of an additional placebo effect (perhaps due to the novelty of taking a combination treatment after months or years of taking LT4 alone) cannot be ruled out. Overall, the literature results suggest that QoL is markedly improved-but not always normalized-by several months of LT4 treatment in newly diagnosed patients with overt hypothyroidism.

BACKGROUNDHypothyroidism causes many symptoms related to low thyroid hormone levels, including feeling tired, feeling cold, dry skin and weight gain. Treating hypothyroidism by replacing thyroxine, the main hormone produced by the thyroid gland, resolves the symptoms of hypothyroidism in the majority of patients. However, many patients with a diagnosis of hypothyroidism report a decreased quality of life compared to people without hypothyroidism. This has been reported in patients on treatment as well as those untreated.

What happens if I miss a dose?

At the American Thyroid Association, part of our motto is optimal thyroid health for all. I think we very much are interested in that, but we’re worried that patients are getting exposed to contents that are not going to benefit or might even harm them. Then, if we’ve identified that they definitely have thyroid problems, we talk about the available therapies with data behind them. Research has been done, we have clinical experience, and there’s oversight on those products, and we talk about the options. I’d actually recommend actively avoiding them because they have an unregulated amount of hormone content.

Lastly, three studies reported significantly worse QoL in LT4-treated patients with overt hypothyroidism, relative to control patients with other diseases and to general population samples (66,73,86. This study reported on the real-world comparative effectiveness of persistent Synthroid compared with persistent GL treatment in a managed care setting using a large longitudinal sample. At 12-month follow-up, a significantly higher proportion of patients in the Synthroid cohort were within both the broad (78.5% vs. 77.2%) and narrower (75.2% vs. 73.9%) TSH reference ranges compared with the GL cohort. Levothyroxine monotherapy (Synthroid® or multiple generic levothyroxine GL formulations) is standard treatment for hypothyroidism.