Real Practice Assessment of Persistent Symptoms After Initiation of Levothyroxine.

Autor:	Hidalgo J; Knowledge and Evaluation Research Unit in Endocrinology, Mayo Clinic, Rochester, Minnesota., Vallejo BA; Department of Cardiology, Mayo Clinic, Rochester, Minnesota., Soto Jacome C; Knowledge and Evaluation Research Unit in Endocrinology, Mayo Clinic, Rochester, Minnesota., Ayala IN; Knowledge and Evaluation Research Unit in Endocrinology, Mayo Clinic, Rochester, Minnesota., Cordova S; Department of Cardiology, Mayo Clinic, Rochester, Minnesota., Duran M; Knowledge and Evaluation Research Unit in Endocrinology, Mayo Clinic, Rochester, Minnesota., Golembiewski E; Knowledge and Evaluation Research Unit in Endocrinology, Mayo Clinic, Rochester, Minnesota., Toro-Tobon D; Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, Minnesota., Brito JP; Knowledge and Evaluation Research Unit in Endocrinology, Mayo Clinic, Rochester, Minnesota; Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Rochester, Minnesota. Electronic address: brito.juan@mayo.edu.
Jazyk:	angličtina
Zdroj:	Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists [Endocr Pract] 2024 Feb; Vol. 30 (2), pp. 95-100. Date of Electronic Publication: 2023 Oct 31.
DOI:	10.1016/j.eprac.2023.10.132
Abstrakt:	Objective: Levothyroxine (LT4) is the standard treatment for hypothyroidism. However, certain patients experience persistent symptoms even after achieving euthyroid status with LT4 therapy. We aimed to determine the frequency of persistent or new symptoms in patients with hypothyroidism after initiating LT4. Methods: This retrospective study included patients with hypothyroidism who started on LT4 between January 2017 and December 2019 at Mayo Clinic in Rochester, Minnesota, USA. Five hundred patient charts were randomly selected for review. Patients with at least 1 documented follow-up encounter after LT4 initiation were evaluated for ≤3 follow-up visits regarding their biochemical status and symptoms. Results: We included 356 patients, a majority of whom were female (66.6%), white (92.3%), and obese (71.9%), with an average age of 59.5 years. At the baseline visit, approximately one-half of the patients (177/356, 47.7%) reported hypothyroid symptoms, with fatigue being the most common symptom. During the follow-up periods, we observed that 17.8% (28/157), 17.9% (19/106), and 19.3% (11/57) of patients had normal thyroid stimulating hormone (TSH) values but persistent symptoms, while 12.3% (19/156), 19.9% (16/107), and 8.9% (5/56) had normal TSH values but new symptoms. Overall, during each respective follow-up period, 26.7% (42/157), 27.3% (29/106), and 28% (16/57) of patients experienced persistent or new symptoms alongside normal TSH values, with fatigue being the most constant symptom. Conclusion: Our findings indicate that approximately 1 in every 4 patients with hypothyroidism receiving LT4 therapy and achieving normal TSH levels experience persistent or new hypothyroid symptoms. The cause of these symptoms remains unclear, emphasizing the need for a better understanding of their underlying causes and the development of effective management strategies. Competing Interests: Disclosure The authors have no multiplicity of interest to disclose. (Copyright © 2023 AACE. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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