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When using LT4 monotherapy, is monitoring of TSH sufficient to guide therapy? Can you elaborate on this?

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When using LT4 monotherapy, is monitoring of TSH sufficient to guide therapy? Can you elaborate on this?

Published: May 4, 2021

When using LT4 monotherapy, is monitoring of TSH sufficient to guide therapy? Can you elaborate on this?

Overview

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When using LT4 monotherapy, is monitoring of TSH sufficient to guide therapy? Can you elaborate on this?

Created by

CMEducation Resources IQ&A Thyroid Hormone Replacement Medical Intelligence Zone

Presenter

Francesco Saverio Celi, MD, MHSc

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 Director, VCU Health Diabetes Program Richmond, Virginia

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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?

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?

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?

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?

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?

Is it preferable to use DTE as a stand-alone combination therapy to substitute for LT4, or can/should it be used to supplement LT4 monotherapy? And what is the safety profile of DTE? And what is the monitoring strategy for combination therapy?

Is it preferable to use DTE as a stand-alone combination therapy to substitute for LT4, or can/should it be used to supplement LT4 monotherapy? And what is the safety profile of DTE? And what is the monitoring strategy for combination therapy?

Once we decide to treat a patient with laboratory findings and a clinical presentation compatible with hypothyroidism, how do we initiate treatment with synthetic LT4? How do we monitor with respect to LT4, T3, TSH, and their global health?

Once we decide to treat a patient with laboratory findings and a clinical presentation compatible with hypothyroidism, how do we initiate treatment with synthetic LT4? How do we monitor with respect to LT4, T3, TSH, and their global health?

Once we decide to treat a patient with laboratory findings and a clinical presentation compatible with hypothyroidism, how do we initiate treatment with synthetic LT4? How do we monitor with respect to LT4, T3, TSH, and their global health?

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?

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?

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?

How would you summarize your experience with hypothyroidism, in particular, your perspective on the current role of combination therapy with DTE?

How would you summarize your experience with hypothyroidism, in particular, your perspective on the current role of combination therapy with DTE?

How would you summarize your experience with hypothyroidism, in particular, your perspective on the current role of combination therapy with DTE?

Can you discuss the consensus report on identifying a subset of patients with hypothyroidism who fail to achieve optimal symptomatic resolution with LT4 monotherapy; and, therefore, should be considered for combination T4/T3 combination therapy?

Can you discuss the consensus report on identifying a subset of patients with hypothyroidism who fail to achieve optimal symptomatic resolution with LT4 monotherapy; and, therefore, should be considered for combination T4/T3 combination therapy?

Can you discuss the consensus report on identifying a subset of patients with hypothyroidism who fsaol to achieve optimal symptomatic resolution with LT4 monotherapy; and, therefore, should be considered for combination T4/T3 combination therapy?

The recognition that LT4 monotherapy is inadequate for producing symptomatic improvement in many patients has led to the formation of an international working group focused on identifying such patients. Can you share your experience with this group?

The recognition that LT4 monotherapy is inadequate for producing symptomatic improvement in many patients has led to the formation of an international working group focused on identifying such patients. Can you share your experience with this group?

The recognition that LT4 monotherapy is inadequate for producing symptomatic improvement in many patients has led to the formation of an international working group focused on identifying such patients. Can you share your experience with this group?

Can you summarize the current treatment challenges for hypothyroidism as encountered by a broad spectrum of clinicians, including primary care, internal medicine, endocrine, women’s health, and geriatric specialists?

Can you summarize the current treatment challenges for hypothyroidism as encountered by a broad spectrum of clinicians, including primary care, internal medicine, endocrine, women’s health, and geriatric specialists?

Can you summarize the current treatment challenges for hypothyroidism as encountered by a broad spectrum of clinicians, including primary care, internal medicine, endocrine, women’s health, and geriatric specialists?