November 29, 2022

Listen to the translation into Italian here:

It used to be thought that when a person has a thyroidectomy giving them back levothyroxine would completely replace the thyroid hormones that were missing when the person had their thyroid removed in fact some people even called levothyroxine therapy a thyroid transplant but we now know that there are some patients not all by any means but some patients who despite

Having normal thyroid function tests blood tests still do not feel normal they don’t feel the way they did before they had their thyroid removed now why would that be and there are many explanations for this one is a simple one they’ve had thyroid cancer they may be depressed or they’ve had surgery and they may be tired and having complications from that they may

Now be on a medication that they were not on before so there are many reasons that a person may not be feeling exactly the way they were before but it’s also possible that the medication is in fact not a thyroid transplant that even though the blood tests seem to be normal there may be other things that the thyroid gland produces that are not present in exactly

Normal concentrations in that patients blood and the thing that people have focused on mostly is another hormone called t3 so in a normal person tea for the both i roxon is converted into t3 but it may be that there’s a subset of people that do not convert t4 into t3 as efficiently as the average person and so there’s a thought now that there are some people who

Might benefit from a combination of t4 plus t3 therapy this is again a very small minority of people because most people feel okay but a small subset maybe ten fifteen percent of people may benefit from a combination of these two hormones the problem is that it’s difficult to give t3 therapy to people because it has a very short half-life in the blood so it has

To be given one or i mean at least two or three times a day so it’s more complicated plus it means giving a person two different medications and so this has not been generally accepted by the medical community i think for most patients the traditional tablets are satisfactory but there again there is a small group of people who for one reason or another do not

Absorb the tablet promptly and efficiently many people have lack of acid in their stomach elderly people have something called atrophic gastritis so they do not make enough acid and there are just other unknown reasons that people do not absorb the medication and for these people it’s been shown in several studies that the newer formulations either a liquid or a

Soft gel seems to be better also there are some newer data to show that there’s less variability in thyroid function tests in people who take these other newer preparations compared to the tablet but i think for the average person the tablet still is going to be satisfactory but if there’s a problem with the absorption of the medication or variability in thyroid

Hormone levels then a clinician should think of using one of these other preparations

Transcribed from video
Prof. D. S. Cooper – Levothyroxine therapy and thyroid gland functions By ITCO Foundation