American Thyroid Association Quick-Reference GUIDELINES Apps
Issue link: https://eguideline.guidelinecentral.com/i/521958
7 Î Although short-term outcome data in hypothyroid patients suggest that thrice-daily synthetic liothyronine may be associated with beneficial effects on parameters such as weight and lipids, longer-term controlled clinical trials using a longer-acting form of triiodothyronine are needed before considering the endorsement of synthetic liothyronine therapy for routine clinical use. (S-M) Î Although some uncontrolled and nonrandomized data exist concerning successful use of liothyronine in euthyroid patients with depression, larger, prospective randomized placebo-controlled studies are needed to more completely define the potential role of liothyronine in this condition, balancing the risks and benefits of therapy to measurable clinical outcomes. (W-L) Î The ATA recommends against the use of synthetic liothyronine therapy in treating euthyroid patients with obesity, due to a lack of controlled data proving treatment efficacy for this indication. (S-L). Î The ATA recommends against the routine use of compounded thyroid hormones due to concerns about safety and potency and due to the lack of data proving superiority to standard thyroid hormone preparations. (S-L) Note: However, in the case of suspected allerg y to an excipient of standard thyroid hormone preparations that cannot be avoided with a change in brand or dose formulation, including a trial of levothyroxine gel capsules, it may be reasonable to consider use of compounded products, although a controlled study of this approach has not been published. Î The ATA recommends against the use of dietary supplements, nutraceuticals, or other over-the-counter products either in euthyroid individuals or as a means of treating hypothyroidism. We particularly caution against the use of pharmacologic doses of iodine because of the risk of thyrotoxicosis and hypothyroidism in those with intact thyroid glands susceptible to becoming further dysregulated because of underlying thyroid pathology. (S-L). Wilson's Syndrome Î There are no credible scientific data to support the existence of "Wilson's syndrome." The ATA recommends against the use of triiodothyronine escalation therapy for this indication due to a lack of proven treatment benefit and safety concerns relating to the risk of thyrotoxicosis. (S-L).