Thyroid Hormone Replacement
FEATURED AUTHORITIES ON HYPOTHYROIDISM
Click on Speaker to View Their iQ&A Sessions
CAPT(ret) Thanh D. Hoang, DO, MACP, FACE
Professor of Medicine
Uniformed Services University of the Health Sciences
Director, Endocrinology Division
Uniformed Services University of the Health Sciences
Walter Reed National Military Medical Center
Endocrinology, Diabetes & Metabolism
Bethesda, MD
Francesco Saverio Celi, MD, MHSc
Professor of Medicine
Chair, Department of Medicine
James E. C. Walker Endowed Chair
University of Connecticut School of Medicine
Farmington, CT
iQ&A interactive Medical Intelligence Zone welcomes your questions and your participation in the iQ&A community.
Latest Videos |view all videos
Can you discuss initiating and sequencing thyroid hormone replacement—how you monitor patients, guideline-directed therapy, and the importance of metabolic and patient-centric factors in determining when DTE therapy should be considered?
Can you provide a perspective on what subset of patients treated with guideline-directed T4 monotherapy may continue to have persistent hypothyroid symptoms, how large this subpopulation is based on clinical studies, and how you rule out ...
Can you go into the specifics of the North Star trial, in terms of trial design, rationale, and what you were trying to assess as far as DTE-based treatment, including patients’ self-reported outcomes as well as FDA regulatory criteria ...
What is the alternative to using monotherapy with levothyroxine? And what role has desiccated thyroid extract (DTE) played historically in treating hypothyroidism, and what have we learned from this experience?
What are the trials, patient preference studies, and other evidence supporting your approach for deploying DTE in clinically appropriate populations, and in what percentage of patients with hypothyroidism does DTE become the treatment modality of choice?
Despite evidence-based guidelines for thyroid hormone replacement therapy, a significant percentage of patients fail to achieve acceptable/optimal symptom control with T4 monotherapy. What the role is for alternative combination approaches, such as DTE?
How do you decide in those patients in whom you believe combination T4/T3 therapy may be beneficial, whether you add T3 to T4 monotherapy or whether you commit you patients to DTE as the primary strategy for combination therapy?
What is causing the presence of 10-15% of patients with hypothyroidism who are dissatisfied with levothyroxine monotherapy? What is the role of T3 as a causative factor? And what are the implications for combination therapy and/or DTE?
What persistent hypothyroid-related symptoms do you look for to suggest T4 monotherapy may not be the optimal approach?


