What percentage of patients who, for symptomatic reasons, have been switched from LT4 monotherapy to DTE, do you find actually improve on DTE, and what do they report?
When we make a decision uh to move uh from levothyroxine uh to uh other forms of treatments for hypothyroidism, it's very important uh to have a frank discussion uh with the patients. And uh uh I always start saying that I have no idea whether it's gonna work. And uh um I Personally, uh, create a sort of contract with the patients. So what are we looking for are changes uh uh that are beneficial to the patients in the boundaries of normalization of thyroid hormones. And uh um. My personal approach with patients is giving a timeline and say, you know, um, we're gonna get the therapeutic levels uh measuring your thyroid hormone in within 6 weeks, 1 month, 3 months. And then after we get to that point, uh, let's give it 3 months and see how you're doing. And tell me whether it's worth to you or not. Cause uh I'm asking uh you to do stuff. And uh uh it can be costly. Definitely, it takes time, it takes effort. And we need to have a frank discussion whether it's worth uh going forward or not. Undoubtedly my patient population and I have I usually work uh uh as a specialist uh and on referrals uh from other specialists. So my patient's population tends to be a bit selected. And uh among these patients uh uh in which I do embark uh on uh non-levothyroxine therapy. Roughly 1/3 do really well on combination therapy. Another 3, not sure about, uh, and 11 other 3 really has zero improvement. And uh patients that do well are really happy with that. Patients who are With some marginal improvement. Uh, uh, we really need to ask, uh, hard questions to ourselves. And again, is it worth or not? How is it worth your time? And, uh, uh, just let me know and, uh, I'm here to help. Again, uh, as far as I'm concerned, uh, as long as the patient is safe, as long as the thyroid hormone levels are within normal range, there is really no particular concern. With the exception of females that can be pregnant, in that case, the discussion needs to be extremely clear that Non-levothyroxine therapy is not acceptable during pregnancy.
