Socioeconomic influence on treatment with liothyronine and desiccated thyroid extract in Denmark

[helvella]

An interesting paper in that it looks at thyroid treatment from a very different point of view.

Although based in Denmark, I wouldn't be at all surprised to see the same general direction if repeated in many other countries.

Socioeconomic influence on treatment with liothyronine and desiccated thyroid extract in Denmark

in European Thyroid Journal

Authors:Jeppe Lerche la Cour1, Line Tang Møllehave2, Bjarke Røssner Medici1, Christian Zinck Jensen1, Anne Ahrendt Bjerregaard2, and Birte Nygaard

Introduction

High compared with low educational level increases the odds of starting levothyroxine (L-T4) with a normal thyroid-stimulating hormone – the mechanism is most likely patient request. The use of liothyronine (L-T3) and desiccated thyroid extract (DTE) is also speculated to be initiated at patients’ request. Therefore, the primary aim of this study was to evaluate if educational level influences treatment with L-T3 and DTE.

Material and methods

In this register-based cross-sectional study, we included all Danish citizens ≥30 years with redeemed prescription of L-T4, L-T3, or DTE during 2017–2020. We defined educational levels as short, medium, and long (<10 years, 10–12 years, and above 12 years, respectively). The association between educational level and treatment with LT3 or DTE vs only LT4 was analyzed in logistic regression models adjusted for age and sex.

Results

We included 154,360 individuals using thyroid medication of whom 3829 were treated with L-T3 (2.48%) and 430 with DTE (0.28%). The usage was highest among women (3.15%) and the age group 40–49 (5.6%). Longer education compared with short increased the odds of being treated with DTE or L-T3 (medium education odds ratio (OR) 1.61 (95% CI 1.50–1.8) and long education OR 1.95 (95% CI 1.79–2.13)). Test for trend: OR: 1.37 (95% CI 1.31–1.42). Adjustment for other covariates did not affect the results substantially.

Conclusion

Persons with a longer compared to a shorter education are more often treated with either DTE or L-T3, and the usage of these drugs is limited to less than 3% of thyroid hormone users.

etj.bioscientifica.com/view...

la Cour, J. L., Møllehave, L. T., Medici, B. R., Jensen, C. Z., Bjerregaard, A. A., & Nygaard, B. (2022). Socioeconomic influence on treatment with liothyronine and desiccated thyroid extract in Denmark, European Thyroid Journal, 11(6), e220149. Retrieved Oct 30, 2022, from etj.bioscientifica.com/view...

[TSH110]

I wonder why? Better knowledge or research abilities, better communicators, more respected…or feared…by health care providers, richer?

[Thyroid17]

I agree, without the ability to access online facilities to search for knowledge, such as this forum and Thyroid UK, I personally would not have found the path to tests, T3 etc and would not enjoy an acceptable level of health (possibly not even be here, based on my own mother's early passing due to undiagnosed). There is no doubt that education and finances directly affect health in relation to thyroid conditions. At times, I have faced financial challenges in obtaining tests and medication. However, if this had not been an issue, I may have proven poor conversion earlier. My current GP now supports me although others have labelled me 'neurotic' and 'in denial'. Without my limited education and confidence to politely speak up for myself I would have been ignored as my health plummeted. I appreciate GP's hands are tied to a certain degree but truly hearing what the patient has to say (and believe) should be practiced by all. I have often thought how many patients, heavily burdened with the decline in their health, are unnecessarily lost as they lack the knowledge, or access to it.

[gabkad]

Less than 3% of 154,360 patients were taking either T3 or DTE. What percent of all the patients had an education >12 years?

What is >12 years? Post high school? And how many of these patients had only a grade 9 or less education?

Oh wow!:

As of 2021, 24 percent of the population in Denmark had primary school as their highest completed education. Nevertheless, the population is becoming increasingly more educated, and nearly 30 percent of Danes had completed a vocational education that year.

statista.com/topics/6821/ed...

[tattybogle in reply to gabkad]

i think ? 'primary' in Denmark is probably rather different to what we are used to .... i think they stay in 'kindergarten' until about age 6/7 .. then primary starts after that .. so 9 yrs of compulsory 'primary' education would make them 15 ish.