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J Endocrinol Invest. 2016 Dec;39(12):1465-1474. Epub 2016 Jul 29.

Recommendations for treatment of hypothyroidism with levothyroxine and levotriiodothyronine: a 2016 position statement of the Italian Society of Endocrinology and the Italian Thyroid Association.

Author information

1
Department of Clinical Medicine and Surgery, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy. bebiondi@unina.it.
2
Department of Clinical and Experimental Medicine, ASST dei Sette Laghi, Ospedale di Circolo, University of Insubria, Varese, Italy.
3
Unit of Internal Medicine and Endocrinology, Fondazione Salvatore Maugeri and University of Pavia, Pavia, Italy.
4
Department of Experimental Medicine, Medical Pathophysiology, Food and Science and Endocrinology Section, Sapienza University of Rome, Rome, Italy.
5
Endocrinology Unit, Department of Medical Sciences "M. Aresu", University of Cagliari, Cagliari, Italy.
6
Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy.
7
Unità di Endocrinologia, Università Cattolica del Sacro Cuore, Rome, Italy.
8
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
9
Accademia Peloritana dei Pericolanti, Università di Messina, Messina, Italy.

Abstract

Levothyroxine (L-T4) is recommended as lifelong replacement therapy for hypothyroidism. Recent clinical and experimental data support the addition of levotriiodothyronine (L-T3) treatment in some selected hypothyroid patients when their symptoms persist and their quality of life remains impaired despite adequate L-T4 monotherapy. An increase in L-T3 prescriptions has been recently observed in Italy due to availability of different L-T3 formulations, making it possible to clinicians to prescribe L-T3 alone or in combination with L-T4. The aim of the present position statement was to define the correct clinical indications, schedule, duration of treatment and contraindications of combined treatment with L-T4 and L-T3 in hypothyroid patients in an attempt to guide clinicians and to avoid potential adverse effects of overtreatment.

KEYWORDS:

Body weight; Clinical symptoms; Cognition; Deiodinases; Depression; Heart rate and patient preference for combined therapy; Hypothyroidism; L-Thyroxine; L-Triiodothyronine; Mood; Polymorphism in type 2 deiodinase gene; Quality of life; Replacement therapy; TSH-suppressive therapy; Thyroidectomized patients

PMID:
27473077
DOI:
10.1007/s40618-016-0511-z
[Indexed for MEDLINE]

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