Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Is there a role for natural desiccated thyroid in the treatment of levothyroxine unresponsive hypothyroidism? Results from a consecutive case series

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Oral Treatment of Glucocorticoid-Induced Diabetes Mellitus: A Systematic Review

    Research output: Contribution to journalLetterpeer-review

  2. Determinants of sexual function and dysfunction in men and women with stroke: A systematic review

    Research output: Contribution to journalReviewpeer-review

  1. Long term outcome after toxic nodular goitre

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Quality of life following lobectomy versus total thyroidectomy is significantly related to hypothyroidism

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. The effect of laser thermal ablation on quality of life: Improvements in patients with solid-cystic thyroid nodules

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Approach to the patient with glucocorticoid-induced adrenal insufficiency

    Research output: Contribution to journalReviewpeer-review

  5. Implementation of thyroid-related patient-reported outcomes in routine clinical practice

    Research output: Contribution to journalReviewpeer-review

  • Adrian H Heald
  • Lakdasa Premawardhana
  • Peter Taylor
  • Onyebuchi Okosieme
  • Tasneem Bangi
  • Holly Devine
  • Mark Livingston
  • Ahmed Javed
  • Gabriela Y C Moreno
  • Torquil Watt
  • Mike Stedman
  • Colin Dayan
  • Dyfrig A Hughes
View graph of relations

INTRODUCTION: Some levothyroxine unresponsive individuals with hypothyroidism are prescribed a natural desiccated thyroid (NDT) preparation such as Armour Thyroid® or ERFA Thyroid® . These contain a mixture of levothyroxine and liothyronine in a fixed ratio. We evaluated the response to NDT in individuals at a single endocrine centre in terms of how the change from levothyroxine to NDT impacted on their lives in relation to quality of life (QOL) and thyroid symptoms.

METHODS: The ThyPRO39 (thyroid symptomatology) and EQ-5D-5L-related QoL/EQ5D5L (generic QOL) questionnaires were administered to 31 consecutive patients who had been initiated on NDT, before initiating treatment/6 months later.

RESULTS: There were 28 women and 3 men. The dose range of NDT was 60-180 mg daily. Age range was 26-77 years with length of time since diagnosis with hypothyroidism ranging from 2 to 40 years. One person discontinued the NDT because of lack of response; two because of cardiac symptoms. EQ-5D-5L utility increased from a mean (SD) of 0.214 (0.338) at baseline, to 0.606 (0.248) after 6 months; corresponding to a difference of 0.392 (95% CI 0.241-0.542), t = 6.82, P < .001. EQ-VAS scores increased from 33.4 (17.2) to 71.1 (17.5), a difference of 37.7 (95% CI 25.2-50.2), t = -4.9, P < .001. ThyPRO scores showed consistent fall across all domains with the composite QoL-impact Score improving from 68.3 (95% CI 60.9-75.7) to 25.2 (95% CI 18.7-31.7), a difference of 43.1 (95% CI 33-53.2) (t = 5.6, P < .001).

CONCLUSION: Significant symptomatic benefit and improvement in QOL was experienced by people with a history of levothyroxine unresponsive hypothyroidism treated with NDT, suggesting the need for further evaluation of NDT in this context.

Original languageEnglish
Article numbere14967
JournalInternational Journal of Clinical Practice
Volume75
Issue number12
Pages (from-to)e14967
ISSN1368-5031
DOIs
Publication statusPublished - Dec 2021

Bibliographical note

© 2021 John Wiley & Sons Ltd.

    Research areas

  • Adult, Aged, Female, Humans, Hypothyroidism/drug therapy, Male, Middle Aged, Quality of Life, Thyroxine, Triiodothyronine

ID: 75181330