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Hypothyroidism Research Paper

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Hypothyroidism is defined as failure of the thyroid gland to produce sufficient thyroid hormone to meet the metabolic demands of the body.1 If left untreated it can contribute to dyslipidemia, hypertension, cognitive impairment, infertility, and neuromuscular dysfunction. One in 200 persons in the United States has hypothyroidism based on the data from National Health and Nutrition Examination Survey (NHANES III).1 The prevalence increases with age, and is higher in females than in males.1

Primary gland failure or insufficient thyroid gland stimulation by the hypothalamus or pituitary gland are the possible causes of hypothyroidism.1 Primary gland failure can result from congenital abnormalities, autoimmune destruction (Hashimoto disease), …show more content…

LT4 has long half-life and slow intestinal absorption, which produces stable serum TSH, T4, and T3 levels with minimal diurnal variation.2 There are no high-quality RCTs that compared the safety and efficacy of name brand LT4 with generic LT4 products. The FDA requires all LT4 preparations to contain between 95% and 105% of the stated amount of LT4. Due to the narrow therapeutic index of LT4 even small differences in bioavailability between formulations may cause clinical hyper- or hypothyroidism. Experts recommend using LT4 from a single manufacturer, which is easier to do with name brand than generic products, especially because the differences in cost are small. The average LT4 replacement dose in adults with overt hypothyroidism is 1.6mcg/kg/day and the calculation is based on ideal body weight.2 PK’s ideal body weight is 59.3kg. The dose for PK would be 94.9 mcg or rounding up to …show more content…

Eleven randomized trials were included, in which 1216 patients were randomized. The meta-analysis concluded that the T4-T3 combination therapy used as replacement therapy for patients treated for hypothyroidism provided no advantage when compared with standard T4 monotherapy. No difference was found in the effectiveness of the combination therapy or monotherapy in any of the following symptoms (fatigue, bodily pain, depression anxiety) and no improvement in quality of life. Lipid profile was not improved in patients prescribed combination therapy, and no differences in weight change. Adverse events did not differ between regimens. Therefore, T4 monotherapy should remain the treatment of choice for clinical hypothyroidism.

Liotrix is a combination of T4 and T3 in a 4:1 ratio that attempts to mimic natural hormonal secretion.3 It is pure and chemically stable and has a predictable potency. It has several disadvantages, such as high cost and lack of therapeutic rationale, because most T3 is peripherally converted from

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