Hypothyroidism Treatment

Treatment

Pharmacotherapy

Levothyroxine

1st-line agent for treatment of hypothyroidism
May be used to manage myxedema coma
Safe for use in pregnancy
Actions:
- Used as a replacement therapy in hypothyroidism to substitute thyroid hormone
- Long half-life (T_½), slow onset, regular bioconversion which is appropriately regulated by the tissues to the biologically active compound T₃

Effects: Safe and predictable effects
- Requires several weeks to achieve peak therapeutic effects with regular oral dosing

Due to different bioavailability of the various preparations of Levothyroxine, patients are encouraged to use the same brand of Levothyroxine
- If a change in brand is needed, the patient’s serum TSH should be retested every 6 weeks and dosage of Levothyroxine be re-titrated

Liothyronine

Actions:
- Short T_½, rapid onset
- Biologically active compound (no conversion is necessary)
- Used as a replacement therapy in hypothyroidism to substitute thyroid hormone

Generally not recommended for routine treatment of hypothyroidism due to its rapid onset and turnover which requires more frequent administration and increases the risk of hyperthyroidism
Useful in management of myxedema coma (when its rapid onset and short duration of action are required)
Effects: Require 3 days to achieve peak therapeutic effects

Note: Desiccated thyroid hormones (with variable proportion of T₃ and T₄), combinations of thyroid hormones and T₃ alone are generally not recommended for treatment of hypothyroidism.

Dapagliflozin DELIVERs across full HF spectrum regardless of LVEF

Elvira Manzano, 04 Oct 2022

The selective, oral sodium–glucose cotransporter 2 (SGLT2) inhibitor dapagliflozin reduces the risk of cardiovascular (CV) death or worsening heart failure (HF) in patients with HF and mildly reduced or preserved ejection fraction (HFmrEF or HFpEF) in the phase III DELIVER* trial, touted as the largest and most inclusive thus far in this patient group.

Navigating the CPP patient journey – case-based discussion for nurses

06 May 2021

In a webinar held on 27 March 2021, paediatric endocrinology nurses Karen Blair, Kate Davies, and Siti Zarina Yaakop shared insights and clinical experience based on their frontline roles in caring for patients with central precocious puberty (CPP) and supporting their family members.

Empagliflozin’s cardiovascular benefits lead the change in T2D treatment paradigm

11 May 2020

This second issue revisits the impact EMPA-REG OUTCOME had on clinical practice and helps readers discover how it gives life back to patients through its cardiovascular indication. Learn how it was approved and the possible mechanisms for its cardiovascular benefits.