Effect of once weekly oral levothyroxine therapy
Open accessAbstract
SUMMARY: Primary hypothyroidism is one of the most common endocrine disorders with widely available treatment. A minority of patients remain with uncontrolled hypothyroidism despite therapy. The objective of this case series was to demonstrate that medication non-adherence, rather than malabsorption, should be sought as the most common cause of unsuppressed TSH levels in patients receiving treatment for this condition. Non-adherence is often considered as a diagnosis of exclusion. Nonetheless, a diagnosis of malabsorption requires a more extensive workup, including imaging and invasive procedures, which increase healthcare costs and burden to the patient. The findings of this study allow for a cost-effective approach to uncontrolled hypothyroidism. LEARNING POINTS: Medication non-adherence is a common cause of insuppressible TSH levels. Once weekly levothyroxine is an alternative approach to non-compliant patients. Assessing compliance is more cost-effective and less burdensome than testing for malabsorption.
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IM or IV injection of LT4 once or twice weekly may also eliminate hypothyroidism due to pseudomalabsorption.
“In addition, IM or IV injection of LT4 once or twice weekly may also eliminate hypothyroidism due to pseudomalabsorption (128, 135, 138).”
From Levothyroxine: conventional and novel drug delivery formulations. (2023) · cites this paper as [138]
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Treatment of Hypothyroidism with Once Weekly Thyroxine1
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Levothyroxine: conventional and novel drug delivery formulations.
Liu, H., Li, W., Zhang, W., Sun, S., & Chen, C. (2023) · Endocrine Reviews · doi:10.1210/endrev/bnac030 · Cited by 63 · see citing works
- Authors
- Toro-Diez, A. D., Solá-Sánchez, E., & Mangual-García, M.
- Affiliations
- San Juan City Hospital (PR)
- 1Endocrinology Department, San Juan City Hospital, San Juan, Puerto Rico
- Corresponding author
- Toro-Diez, Andrea del
- Venue
- Endocrinology, Diabetes & Metabolism Case Reports
- Publisher
- Bioscientifica
- Published
- 2021-07-01
- Volume
- 2021
- ISSN
- 2052-0573 (ISSN-L)
- PMC
- PMC8284960
- OpenAlex
- W3177486707
- Cited by
- 6
- References
- 11
- Citations by year
- 2024: 3 · 2023: 1 · 2022: 1 · 2021: 1
- FWCI
- 1.12
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Endocrinology Diabetes and Metabolism Case Reports (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Keywords
- primary hypothyroidism, levothyroxine, weekly dosing, medication non-adherence, TSH suppression, malabsorption, thyroid hormone replacement, cost-effectiveness
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