Use of thyroid hormones in hypothyroid and euthyroid patients: a 2020 THESIS questionnaire survey of members of the Hellenic Endo Society

[helvella]

We have often discussed Greece and their use of T3 (*liothyronine) - moist especially due to the very reasonable price of their own T3 product from Uni-Pharma.

For that reason, I half-expected an article regarding thyroid treatment in Greece to see T3 rather more visible than in the UK.

Whilst they might be somewhat more amenable than UK doctors, they do not appear as we might have expected.

And the title alone begs the question as to what constitutes a euthyroid patient?

• Original Article

• Published: 09 November 2021

Use of thyroid hormones in hypothyroid and euthyroid patients: a 2020 THESIS questionnaire survey of members of the Hellenic Endocrine Society.

• Stavroula A. Paschou,

• Maria Alevizaki,

• Roberto Attanasio,

• Laszlo Hegedüs,

• Endre V. Nagy,

• Enrico Papini,

• Petros Perros &

• Andromachi Vryonidou

Hormones (2021)

Abstract

Purpose

To investigate current practices of specialists in the use of thyroid hormone preparations in Greece as part of an ongoing international survey, namely THESIS—Treatment of Hypothyroidism in Europe by Specialists: an International Survey.

Methods

An electronic link leading to an anonymized questionnaire was sent to all (n= 837) members of the Hellenic Endocrine Society.

Results

In total, 501 respondents participated in the survey, though only part of the questionnaire was filled in by some participants. A total of 88.2% were endocrinologists and 57.9% worked in private practice. Levothyroxine (LT4) was the first-line choice (98.6%) for the treatment of hypothyroid patients. In total, 70.2% preferred LT4 soft-gel capsules for patients reporting intolerance to various foods. Soft-gel capsules were the preferred LT4 formulation for patients on generic LT4 and with unexplained poor biochemical control of hypothyroidism (66.3%) or inability to take LT4 fasted and separate from food/drink (68.3%). It was found that 48.4% would never use combined LT4 + LT3. However, 25% would use combination therapy for a short period in patients recovering from protracted hypothyroidism or in patients with normal serum TSH but persistent symptoms. Concerning euthyroid individuals, 31.9% considered treatment with thyroid hormones in infertile females with positive thyroid antibodies and 24.4% in patients with growing goiter. Selenium or iodine supplementation was used occasionally, mostly in patients with coexisting autoimmune thyroiditis.

Conclusions

LT4 tablets are the treatment of choice for hypothyroidism in Greece. Several conditions may lead to various other practices, some of which deviate from current evidence-based guidelines and need more scrutiny.

Full article behind paywall:

link.springer.com/article/1...

[janeroar]

V odd use of language in this paper, as though written by someone who knows nothing about the subject eg ‘recovering from protracted hypothyroidism’ -well yes it normally is!!

[helvella Administrator Thyroid UK in reply to janeroar]

Well, it's (much) better than my Greek. Which extends to yes, no and orange drink.

But I do know what you mean. I quite often wonder if major parts of published papers were written by an office junior, or someone else who isn't actually practising? Even if read over by others.

[janeroar in reply to helvella]

Yes agree -it’s not the standard of English but the ignorance of medical knowledge that is worrying!

[Marz]

Thank you for this post. I have not read the paper. I would like to mention my own experience of living in Greece for 15 years from 2004.

I was diagnosed with Hashimotos in 2005 and started on T4. I found both GP's and Endos very open to the importance of FULL testing of thyroid hormones which resulted in an additional prescription for T3. Scans also routinely carried out to confirm a diagnosis.

I purchased both T4 and T3 OTC for just over a euro. This continued for many years and then I sensed the winds of change ? I then needed a prescription for T3 which was renewed annually. My local chemist followed the new rules to the letter. Of course we know many pharmacies sold T3 - as reported here. Stocks kept low too ....

I fear the changes coincided with restrictions elsewhere and cannot help thinking orders came from those that have the financial power to control and keep people sick.

As John Iaoniddes said - research today is about the prevailing bias ! ( In order to be published ! )

[Poniesrfun]

Wonder what the questions used in the survrey were? How the questions are worded affects the survey results and can be slanted to get the results they wanted.

Patti in AZ