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Is there a role for Natural Desiccated Thyroid in the treatment of levothyroxine unresponsive hypothyroidism? Results from a Consecutive Case Series. / Heald, Adrian; Premawardhana, Lakdasa; Taylor, Peter et al.
In: International Journal of Clinical Practice, Vol. 75, No. 12, e14967, 28.12.2021.

Research output: Contribution to journalArticlepeer-review

HarvardHarvard

Heald, A, Premawardhana, L, Taylor, P, Okosieme, O, Bangi, T, Devine, H, Livingston, M, Javed, A, Moreno, GYC, Watt, T, Stedman, M & Hughes, D 2021, 'Is there a role for Natural Desiccated Thyroid in the treatment of levothyroxine unresponsive hypothyroidism? Results from a Consecutive Case Series', International Journal of Clinical Practice, vol. 75, no. 12, e14967. https://doi.org/10.1111/ijcp.14967

APA

Heald, A., Premawardhana, L., Taylor, P., Okosieme, O., Bangi, T., Devine, H., Livingston, M., Javed, A., Moreno, G. Y. C., Watt, T., Stedman, M., & Hughes, D. (2021). Is there a role for Natural Desiccated Thyroid in the treatment of levothyroxine unresponsive hypothyroidism? Results from a Consecutive Case Series. International Journal of Clinical Practice, 75(12), Article e14967. https://doi.org/10.1111/ijcp.14967

CBE

Heald A, Premawardhana L, Taylor P, Okosieme O, Bangi T, Devine H, Livingston M, Javed A, Moreno GYC, Watt T, et al. 2021. Is there a role for Natural Desiccated Thyroid in the treatment of levothyroxine unresponsive hypothyroidism? Results from a Consecutive Case Series. International Journal of Clinical Practice. 75(12):Article e14967. https://doi.org/10.1111/ijcp.14967

MLA

VancouverVancouver

Heald A, Premawardhana L, Taylor P, Okosieme O, Bangi T, Devine H et al. Is there a role for Natural Desiccated Thyroid in the treatment of levothyroxine unresponsive hypothyroidism? Results from a Consecutive Case Series. International Journal of Clinical Practice. 2021 Dec 28;75(12):e14967. Epub 2021 Oct 9. doi: https://doi.org/10.1111/ijcp.14967

Author

Heald, Adrian ; Premawardhana, Lakdasa ; Taylor, Peter et al. / Is there a role for Natural Desiccated Thyroid in the treatment of levothyroxine unresponsive hypothyroidism? Results from a Consecutive Case Series. In: International Journal of Clinical Practice. 2021 ; Vol. 75, No. 12.

RIS

TY - JOUR

T1 - Is there a role for Natural Desiccated Thyroid in the treatment of levothyroxine unresponsive hypothyroidism? Results from a Consecutive Case Series

AU - Heald, Adrian

AU - Premawardhana, Lakdasa

AU - Taylor, Peter

AU - Okosieme, Onyebuchi

AU - Bangi, Tasneem

AU - Devine, Holly

AU - Livingston, Mark

AU - Javed, Ahmed

AU - Moreno, Gabriela Y.C.

AU - Watt, Torquil

AU - Stedman, Mike

AU - Hughes, Dyfrig

PY - 2021/12/28

Y1 - 2021/12/28

N2 - Introduction: Some levothyroxine unresponsive individuals with hypothyroidism are prescribed a natural desiccated thyroid (NDT) preparation such as Armour Thyroid® or ERFA Thyroid® . These contain a mixture of levothyroxine and liothyronine in a fixed ratio. We evaluated the response to NDT in individuals at a single endocrine centre in terms of how the change from levothyroxine to NDT impacted on their lives in relation to quality of life (QOL) and thyroid symptoms. Methods: The ThyPRO39 (thyroid symptomatology) and EQ-5D-5L-related QoL/EQ5D5L (generic QOL) questionnaires were administered to 31 consecutive patients who had been initiated on NDT, before initiating treatment/6 months later. Results: There were 28 women and 3 men. The dose range of NDT was 60-180 mg daily. Age range was 26-77 years with length of time since diagnosis with hypothyroidism ranging from 2 to 40 years. One person discontinued the NDT because of lack of response; two because of cardiac symptoms. EQ-5D-5L utility increased from a mean (SD) of 0.214 (0.338) at baseline, to 0.606 (0.248) after 6 months; corresponding to a difference of 0.392 (95% CI 0.241-0.542), t = 6.82, P < .001. EQ-VAS scores increased from 33.4 (17.2) to 71.1 (17.5), a difference of 37.7 (95% CI 25.2-50.2), t = -4.9, P < .001. ThyPRO scores showed consistent fall across all domains with the composite QoL-impact Score improving from 68.3 (95% CI 60.9-75.7) to 25.2 (95% CI 18.7-31.7), a difference of 43.1 (95% CI 33-53.2) (t = 5.6, P < .001). Conclusion: Significant symptomatic benefit and improvement in QOL was experienced by people with a history of levothyroxine unresponsive hypothyroidism treated with NDT, suggesting the need for further evaluation of NDT in this context.

AB - Introduction: Some levothyroxine unresponsive individuals with hypothyroidism are prescribed a natural desiccated thyroid (NDT) preparation such as Armour Thyroid® or ERFA Thyroid® . These contain a mixture of levothyroxine and liothyronine in a fixed ratio. We evaluated the response to NDT in individuals at a single endocrine centre in terms of how the change from levothyroxine to NDT impacted on their lives in relation to quality of life (QOL) and thyroid symptoms. Methods: The ThyPRO39 (thyroid symptomatology) and EQ-5D-5L-related QoL/EQ5D5L (generic QOL) questionnaires were administered to 31 consecutive patients who had been initiated on NDT, before initiating treatment/6 months later. Results: There were 28 women and 3 men. The dose range of NDT was 60-180 mg daily. Age range was 26-77 years with length of time since diagnosis with hypothyroidism ranging from 2 to 40 years. One person discontinued the NDT because of lack of response; two because of cardiac symptoms. EQ-5D-5L utility increased from a mean (SD) of 0.214 (0.338) at baseline, to 0.606 (0.248) after 6 months; corresponding to a difference of 0.392 (95% CI 0.241-0.542), t = 6.82, P < .001. EQ-VAS scores increased from 33.4 (17.2) to 71.1 (17.5), a difference of 37.7 (95% CI 25.2-50.2), t = -4.9, P < .001. ThyPRO scores showed consistent fall across all domains with the composite QoL-impact Score improving from 68.3 (95% CI 60.9-75.7) to 25.2 (95% CI 18.7-31.7), a difference of 43.1 (95% CI 33-53.2) (t = 5.6, P < .001). Conclusion: Significant symptomatic benefit and improvement in QOL was experienced by people with a history of levothyroxine unresponsive hypothyroidism treated with NDT, suggesting the need for further evaluation of NDT in this context.

U2 - https://doi.org/10.1111/ijcp.14967

DO - https://doi.org/10.1111/ijcp.14967

M3 - Article

VL - 75

JO - International Journal of Clinical Practice

JF - International Journal of Clinical Practice

SN - 1742-1241

IS - 12

M1 - e14967

ER -