The Emergence of Levothyroxine As a Treatment for Hypothyroidism

Overview

Journal Endocrine

Specialty Endocrinology

Date 2016 Dec 17

PMID 27981511

Citations 25

Authors

James V Hennessey

Affiliations

Soon will be listed here.

Abstract

Objective: To describe the historical refinements, understanding of physiology and clinical outcomes observed with thyroid hormone replacement strategies.

Methods: A Medline search was initiated using the search terms, levothyroxine, thyroid hormone history, levothyroxine mono therapy, thyroid hormone replacement, combination LT4 therapy, levothyroxine Bioequivalence. Pertinent articles of interest were identified by title and where available abstract for further review. Additional references were identified in the course of review of the literature identified.

Results: Physicians have intervened in cases of thyroid dysfunction for more than two millennia. Ingestion of animal thyroid derived preparations has been long described but only scientifically documented for the last 130 years. Refinements in hormone preparation, pharmaceutical production and regulation continue to this day. The literature provides documentation of physiologic, pathologic and clinical outcomes which have been reported and continuously updated. Recommendations for effective and safe use of these hormones for reversal of patho-physiology associated with hypothyroidism and the relief of symptoms of hypothyroidism has documented a progressive refinement in our understanding of thyroid hormone use. Studies of thyroid hormone metabolism, action and pharmacokinetics have allowed evermore focused recommendations for use in clinical practice. Levothyroxine mono-therapy has emerged as the therapy of choice of all recent major guidelines.

Conclusions: The evolution of thyroid hormone therapies has been significant over an extended period of time. Thyroid hormone replacement is very useful in the treatment of those with hypothyroidism. All of the most recent guidelines of major endocrine societies recommend levothyroxine mono-therapy for first line use in hypothyroidism.

Citing Articles

LT4/LT3 Combination Therapy vs. Monotherapy with LT4 for Persistent Symptoms of Hypothyroidism: A Systematic Review.

Vargas-Uricoechea H, Wartofsky L Int J Mol Sci. 2024; 25(17).

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Cellular Responses to Extracellular Vesicles as Potential Markers of Colorectal Cancer Progression.

Guarnerio S, Tempest R, Maani R, Hunt S, Cole L, Le Maitre C Int J Mol Sci. 2023; 24(23).

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Infantile hypothyroidism and its relationship with delayed tooth eruption: A case report.

Carvalho I, Amorim A, da Silva P, de Andrade M, Carvalho E, Freitas R J Clin Exp Dent. 2023; 14(12):e1039-e1043.

PMID: 36601243 PMC: 9799985. DOI: 10.4317/jced.59587.

An Overview on Different L-Thyroxine (l-T) Formulations and Factors Potentially Influencing the Treatment of Congenital Hypothyroidism During the First 3 Years of Life.

Stagi S, Municchi G, Ferrari M, Wasniewska M Front Endocrinol (Lausanne). 2022; 13:859487.

PMID: 35757415 PMC: 9218053. DOI: 10.3389/fendo.2022.859487.

Economic Evaluation of a Pharmacist-Led 5-Day Therapeutic Hold of IV Levothyroxine at an Academic Medical Center.

Barlow B, Roberts R, Newman K, Harrison S, Sin J Hosp Pharm. 2022; 57(1):20-25.

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