The Role, Rationale, Evidence and Practical Application of
Combination Therapy with DTE in Selected Patients with Hypothyroidism
A Year 2021 Hypothyroidism Update for the Endocrinology, Primary Care, Internal Medicine, and Thyroid Specialist
A Year 2021 Hypothyroidism Update for the Endocrinology, Primary Care, Internal Medicine, and Thyroid Specialist
FEATURED AUTHORITIES ON HYPOTHYROIDISM
Click on Speaker to View Their iQ&A Sessions
Professor of Medicine
Department of Medicine
Division of Endocrinology
University of Chicago
Chicago, IL
Christine A. Kessler, MN, ANP-BC, CNS, BC-ADM, FAANP
Founder, Nurse Practitioner Metabolic Medicine Associates
Co-Chair, Metabolic & Endocrine Disease Summit (MEDS)
King George, VA
Francesco Saverio Celi, MD, MHSc
William G. Blackard Professor of Medicine
Chair, Division of Endocrinology
Diabetes and Metabolism Department of Internal Medicine
Virginia Commonwealth University
Richmond, VA
iQ&A interactive Medical Intelligence Zone welcomes your questions and your participation in the iQ&A community.
Latest Videos |view all videos
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How do you evaluate the success of combination therapy? What laboratory and/or symptom parameters do you assess? And how do you initiate combination therapy with synthetic T4 and T3?
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What is the role of the thyroid ultrasound in patients being evaluated for hypothyroidism? And why is confirming the diagnosis critical prior to initiating therapy?
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Once you’ve determined that LT4 therapy is not achieving the desired symptomatic end points, what are the practical aspects of initiating DTE therapy in the PCP setting? What does the DTE roadmap look like for NP Thyroid® and other DTE formulations?
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In addition to recognizing subtle clinical signs of hypothyroidism—fatigue, decreased energy, and other non-specific findings—what are the guideline-consistent benchmarks for laboratory evaluation of a person suspected of having hypothyroidism?
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How will patients with hypothyroidism typically present to clinical care providers, what are the guideline-endorsed protocols for laboratory evaluation, and how do we confirm our treatment strategy has been successful from the patient perspective?
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What is the alternative to using monotherapy with levothyroxine? And what role has dessicated thyroid extract (DTE) played historically in treating hypothyroidism, and what have we learned from this experience?
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In primary care/internal medicine, combination therapy typically consists of DTE as the preferred approach in patients failing to respond to LT4 monotherapy. Can you provide a roadmap for DTE use—including NP Thyroid and other formulations?
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How is laboratory monitoring of persons on LT4 therapy different from patients who are taking combination therapy with a DTE? Do you need to monitor T3 in patients on DTE? What should you be observing with respect to symptomatic improvement?
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Can you review current ATA-consistent guidelines for specific thyroid replacement formulations initially recommended in newly diagnosed persons with hypothyroidism? Why is T4 (levothyroxine) alone usually recommended as opposed to combination T4/T3?
