Table 3 Persistent hypothyroid symptoms and the role of LT3 therapy
From: Thyroid hormone use in clinical practice by Israeli endocrinologists: a THESIS* questionnaire survey
n (%) | |
|---|---|
Some patients treated with LT4 experience hypothyroid symptoms despite normal TSH | |
1. In your practice, how common is this phenomenon? | |
less than 5% of patients | 59 (48.0%) |
6–10% | 38 (30.9%) |
11–30% | 15 (12.2%) |
More than 30% | 1 (0.8%) |
Not sure | 10 (8.1%) |
2. In your experience, what has been the trend over the past 5 years? | |
More | 36 (29.3%) |
Fewer | 8 (6.5%) |
No change | 50 (40.7%) |
Not sure | 29 (23.6%) |
3. With regards to the etiology of this phenomenon, what do you think likely plays a role (one or more) | |
Inability of levothyroxine to restore normal physiology | 56 (45.5%) |
Psychosocial factors | 82 (66.6%) |
Comorbidities | 32 (26%) |
Chronic fatigue syndrome | 28 (22.7%) |
Patient unrealistic expectations | 44 (35.8%) |
Not sure | 26 (21.1%) |
When does administration of both LT4 and LT3 may be considered? | |
For short periods, recovering from protracted hypothyroidism | 11 (8.9%) |
Normal TSH with symptoms suggestive of hypothyroidism | 71 (57.7%) |
Normal TSH with unexplained weight gain | 2 (1.6%) |
Should never be used due to the low quality of evidence | 30 (24.4%) |
No reply | 9 (7.3%) |