Abstract
Levothyroxine (LT4) is a standard therapy in hypothyroidism; however, its bioavailability and therapeutic effects might be affected by many factors. Data shows that therapy with liquid LT4 characterized by quicker pharmacokinetics provides better thyroid hormones control than tablet LT4. We addressed the quality of life (QoL) and efficacy of the new ethanol-free formula of liquid LT4 (Tirosint®SOL) treatment in 76 euthyroid patients with primary (PH, n = 46) and central hypothyroidism (CH, n = 30), and compared the results to retrospective data on equivalent doses of tablet L-T4 therapy. After 8 weeks of liquid LT4 therapy, we found a significant improvement in QoL in both PH and CH patients. TSH levels were unaltered in PH patients. Free hormone levels (fT4 and fT3) increased in all the patients, with the exception of fT3 in the CH group. SHBG and low-density lipoprotein (LDL) also improved. Liquid LT4 therapy provided a better thyroid hormone profile and improvement in patients’ QoL than the tablet form, which was possibly due to the more favorable pharmacokinetics profile resulting in better absorption, as suggested by the increased free thyroid hormone levels. In summary, this is the first study addressing the QoL in hypothyroid patients, including primary and central hypothyroidism, treated with liquid LT4 formula in everyday practice.
Highlights
Hypothyroidism is one of the most common diseases of the endocrine system; subclinical hypothyroidism affects up to 3–15% of the adult population worldwide [1,2]
It is worth emphasizing that the quality of life of patients treated for primary hypothyroidism is reduced despite biochemical euthyroidism in about 10% of patients [6,7,8]
The present observational study showed for the first time that the novel, ethanol-free liquid LT4 is more effective than tablet LT4 in increasing the concentration of free thyroid hormones in euthyroid patient populations with primary and central hypothyroidism
Summary
Hypothyroidism is one of the most common diseases of the endocrine system; subclinical hypothyroidism affects up to 3–15% of the adult population worldwide [1,2]. Synthetic levothyroxine (T4) sodium is the first-line treatment for hypothyroidism, regardless of its cause, in all age groups. The goal of treatment with levothyroxine is to achieve clinical and biochemical euthyroidism, evidenced by the achievement of the desired TSH and/or fT4 concentration, while avoiding drug overdose [3,4,5]. It is worth emphasizing that the quality of life of patients treated for primary hypothyroidism is reduced despite biochemical euthyroidism in about 10% of patients [6,7,8].
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